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New Patients

Your Sleep Therapy Experts

Thank you for choosing Performance Home Medical for all of your sleep therapy needs! We truly appreciate the opportunity to serve you and provide you with the excellent care and one-on-one service that you deserve.

In order to make your sleep journey as efficient as possible, we recommend that our patients fill out our new patient form which gives us the information we need to get started. We’re here to help. Get in touch with us today.

  • Patient Information

  • * - Indicates a required field

  • Have you seen a doctor in the last 6 months? *

    Have you seen a doctor in the last 6 months?
  • Are you currently using supplemental oxygen? *

    Are you currently using supplemental oxygen?
  • Do you have a humidifier? *

    Do you have a humidifier?
  • Once all information is received, do you need to schedule an appointment? *

    Once all information is received, do you need to schedule an appointment?
  • Do you use heated tubing? *

    Do you use heated tubing?
  • Do you use non-heated tubing? *

    Do you use non-heated tubing?
  • Once all information is received do you want the supplies shipped USPS? *

    Once all information is received do you want the supplies shipped USPS?
  • Do you want to pick up the supplies at one of our locations?

    Do you want to pick up the supplies at one of our locations?