IntelliPAP TouchFree Warranty Return Program
  1. Instructions

    1. Ensure you troubleshoot the patient’s problem with their IntelliPAP Troubleshooting Guide
    2. Read the Return and Warranty Policy Terms and Conditions and the Business Associate Agreement below. You cannot submit the Return Form below or return your IntelliPAP unit without reviewing and agreeing to these Terms and Conditions, including the Business Associate Agreement.
      1. All claims submitted before 1pm ET Monday - Friday will be processed and a replacement unit will be shipped the same day. Units that ship out Friday will arrive on Monday.
      2. Please be sure to download therapy information (SmartCode® or SmartLink®) from the IntelliPAP that is being returned. DeVilbiss will not download this data when the unit is received. All information stored in the memory will be deleted.
      3. If you do not provide prescription settings, the replacement IntelliPAP will be shipped with factory default settings.

    NOTE:

    • Patients are to return their IntelliPAP to DeVilbiss within 10 days of receiving their replacement. The DeVilbiss provider will be billed for the replacement unit if the original (defective) unit is not received by DeVilbiss within 30 days. Please refer to the Terms & Conditions for pricing information.
    • The Warranty Period of the replacement unit will be pro-rated as indicated in the Return and Warranty Policy Terms and Conditions below.
  2. All fields marked with a red asterisk are required fields.

  3. Dealer Contact Information

  4. Date*
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  5. Account Number*
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  6. PO Number*
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  7. Dealer/Company Name*
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  8. Contact Name*
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  9. Dealer Address*
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  10. Invalid Input
  11. City*
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  12. State*
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  13. ZIP*
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  14. Phone*
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  15. Email*
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  16. Fax*
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  17. Patient Shipping Information

    Please enter your shipping information if you would like the replacement IntelliPAP unit shipped
    to your location as opposed to the patient.
  18. Name*
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  19. Address*
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  20. Invalid Input
  21. City*
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  22. State*
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  23. ZIP*
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  24. Phone
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  25. Product Information

  26. Serial Number*
    Please enter a valid serial number
  27. IntelliPAP Model*
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  28. Error Code (if applicable)
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  29. Reason For Return*
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  30. Is the IntelliPAP Heated Humidifier (no water chamber) being returned?*


    Invalid Input
  31. Humidifier Serial Number
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  32. Do you require us to set the prescription settings on this device?*


    Invalid Input
  33. Device Settings

    The Device Settings listed below are Standard Factory Settings. If you are unsure of a specific setting for the patient, please do not adjust the settings below.

  34. Language*
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  35. CPAP Pressure*
    Invalid Input
  36. Delay Time*
    Invalid Input
  37. Delay Pressure*
    Invalid Input
  38. Pressure Unit*
    Invalid Input
  39. Low Use Threshold*
    Invalid Input
  40. Auto-OFF*
    Invalid Input
  41. Auto-ON*
    Invalid Input
  42. Notifications*
    Invalid Input
  43. Low (Standby) Backlight*
    Invalid Input
  44. Delay Time Lockout*
    Invalid Input
  45. Auto-ON/OFF*
    Invalid Input
  46. CPAP Pressure*
    Invalid Input
  47. Delay Time*
    Invalid Input
  48. Delay Pressure*
    Invalid Input
  49. Pressure Unit*
    Invalid Input
  50. Tubling Length*
    Invalid Input
  51. Low Use Threshold*
    Invalid Input
  52. SmartFlex*
    Invalid Input
  53. SmartFlex Mode*
    Invalid Input
  54. SmartFlex IPAP Rounding*
    Invalid Input
  55. SmartFlex EPAP Rounding*
    Invalid Input
  56. Auto-OFF*
    Invalid Input
  57. Auto-ON*
    Invalid Input
  58. Mask Fit Check*
    Invalid Input
  59. Notifications*
    Invalid Input
  60. Low (Standby) Backlight*
    Invalid Input
  61. Quick View Menu*
    Invalid Input
  62. Delay Time Lockout*
    Invalid Input
  63. Tubing Length Lockout
    Invalid Input
  64. Auto-ON/OFF*
    Invalid Input
  65. SmartFlex Lockout*
    Invalid Input
  66. Do you want to adjust the advanced settings?


    Invalid Input
  67. Advanced Settings

  68. Apnea %*
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  69. Apnea Duration*
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  70. Hypopnea %*
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  71. Hypopnea Duration*
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  72. Operating Mode*
    Invalid Input
  73. CPAP Pressure*
    Invalid Input
  74. Lower Pressure Limit (LPL)*
    Invalid Input
  75. Upper Pressure Limit (UPL)*
    Invalid Input
  76. Delay Time*
    Invalid Input
  77. Delay Pressure*
    Invalid Input
  78. Pressure Unit*
    Invalid Input
  79. Tubling Length*
    Invalid Input
  80. Low Use Threshold*
    Invalid Input
  81. SmartFlex*
    Invalid Input
  82. SmartFlex Mode*
    Invalid Input
  83. SmartFlex IPAP Rounding*
    Invalid Input
  84. SmartFlex EPAP Rounding*
    Invalid Input
  85. Auto-OFF*
    Invalid Input
  86. Auto-ON*
    Invalid Input
  87. Mask Fit Check*
    Invalid Input
  88. Notifications*
    Invalid Input
  89. Low (Standby) Backlight*
    Invalid Input
  90. Quick View Menu*
    Invalid Input
  91. Delay Time Lockout*
    Invalid Input
  92. Tubing Length Lockout
    Invalid Input
  93. Auto-ON/OFF*
    Invalid Input
  94. SmartFlex Lockout*
    Invalid Input
  95. Do you want to adjust the advanced settings?


    Invalid Input
  96. Advanced Settings

  97. Apnea %*
    Invalid Input
  98. Apnea Duration*
    Invalid Input
  99. Hypopnea %*
    Invalid Input
  100. Hypopnea Duration*
    Invalid Input
  101. Operating Mode
    Invalid Input
  102. CPAP Pressure*
    Invalid Input
  103. EPAP Pressure*
    Invalid Input
  104. IPAP Pressure*
    Invalid Input
  105. EPAP Rounding*
    Invalid Input
  106. IPAP Rounding*
    Invalid Input
  107. Inhale Trigger Sensitivity*
    Invalid Input
  108. Exhale Trigger Sensitivity*
    Invalid Input
  109. Delay Time*
    Invalid Input
  110. Delay Pressure*
    Invalid Input
  111. Pressure Unit*
    Invalid Input
  112. Tubling Length*
    Invalid Input
  113. Low Use Threshold*
    Invalid Input
  114. Auto-OFF*
    Invalid Input
  115. Auto-ON*
    Invalid Input
  116. Mask Fit Check*
    Invalid Input
  117. Notifications*
    Invalid Input
  118. Low (Standby) Backlight*
    Invalid Input
  119. Delay Time Lockout*
    Invalid Input
  120. Tubing Length Lockout
    Invalid Input
  121. Rounding Lockout*
    Invalid Input
  122. Triggering Lockout*
    Invalid Input
  123. Auto-ON/OFF*
    Invalid Input
  124. Operating Mode
    Invalid Input
  125. CPAP Pressure*
    Invalid Input
  126. Max IPAP*
    Invalid Input
  127. Min EPAP*
    Invalid Input
  128. Pressure Support*
    Invalid Input
  129. Delay Time*
    Invalid Input
  130. Delay Pressure*
    Invalid Input
  131. EPAP Rounding*
    Invalid Input
  132. IPAP Rounding*
    Invalid Input
  133. Exhale Trigger Sensitivity*
    Invalid Input
  134. Inhale Trigger Sensitivity*
    Invalid Input
  135. Pressure Unit*
    Invalid Input
  136. Tubling Length*
    Invalid Input
  137. Low Use Threshold*
    Invalid Input
  138. Auto-OFF*
    Invalid Input
  139. Auto-ON*
    Invalid Input
  140. Mask Fit Check*
    Invalid Input
  141. Notifications*
    Invalid Input
  142. Low (Standby) Backlight*
    Invalid Input
  143. Quick View Menu*
    Invalid Input
  144. Delay Time Lockout*
    Invalid Input
  145. Tubing Length Lockout
    Invalid Input
  146. Rounding Lockout*
    Invalid Input
  147. Triggering Lockout*
    Invalid Input
  148. Auto-ON/OFF*
    Invalid Input
  149. Do you want to adjust the advanced settings?


    Invalid Input
  150. Advanced Settings

  151. Apnea %*
    Invalid Input
  152. Apnea Duration*
    Invalid Input
  153. Hypopnea %*
    Invalid Input
  154. Hypopnea Duration*
    Invalid Input
  155. Terms and Conditions*
    Please review the terms and conditions
  156. Your Name*
    Invalid Input
  157. Your Email*
    Invalid Input
  158. Name of Provider*
    Invalid Input
  159.   
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DeVilbiss Healthcare

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