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Online Hire
Application

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IMPORTANT! The hire term is a MINIMUM 6 MONTHS.

IMPORTANT Please complete both Step 1 & 2

Step 1 Of 2. Ezidebit Debit Request - 6 Month Min Hire

Ezidebit Debit Request

Online CPAP Hire – All Cpap Hire payments are processed through our financial partner Ezidebit. You will need to complete the online debit request form with your personal and financial details so the hire fee  can be debited on a monthly basis from your nominated account. You can always change these details at any stage.

  1.  Click on the blue ‘Ezidebit Debit Request‘ Button &  fill in your personal & account details. IMPORTANT For the section that asks for ‘Your Reference‘ you can simply use your name. Please do not fill in the ONCE OFF DEBIT, or you will be charged twice.
  2. Once completed, you will receive a copy of your debit arrangement via email for your records.
CPAP HIRE APPLICATION
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Step 2 Of 2. Upload Identification

Upload your drivers licence or identification - Please use the i.d of the person who will be using the equipment.

Maximum file size: 10MB

Upload your prescription if you have one

Maximum file size: 10MB

T&C Confirmation
CPAP HIRE APPLICATION
Sign Up 100% Complete - We will be in touch if we need any more information. You will receive some shipping information shortly after your first debit date. 100%

By completing the cpap hire form you are agreeing to our CPAP HIRE Terms & Conditions. Thank you

Online CPAP Hire

Quick & Easy

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