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. Is a SmartLink Module being returned?*


    Invalid Input
  33. Is a SmartLink Data Card being returned?*


    Invalid Input
  34. Do you require us to set the prescription settings on this device?*


    Invalid Input
  35. 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.

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


    Invalid Input
  69. Advanced Settings

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


    Invalid Input
  98. Advanced Settings

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


    Invalid Input
  152. Advanced Settings

  153. Apnea %*
    Invalid Input
  154. Apnea Duration*
    Invalid Input
  155. Hypopnea %*
    Invalid Input
  156. Hypopnea Duration*
    Invalid Input
  157. Terms and Conditions*
    Please review the terms and conditions
  158. Your Name*
    Invalid Input
  159. Your Email*
    Invalid Input
  160. Name of Provider*
    Invalid Input
  161.   
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DeVilbiss Healthcare

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