VA2346b

Positive Airway Pressure (PAP) Devices and Supplies

Agency
VA
Revision
July 2020
Fillable fields
22
Pages
1
Official source
VA form page
Checked
October 20, 2026
Fill VA2346b online
Page 1 of form VA2346b

VA Form VA2346b: Positive Airway Pressure (PAP) Devices and Supplies

VA Form VA2346b is the U.S. Department of Veterans Affairs form for Positive Airway Pressure (PAP) Devices and Supplies. VA's form page says to use it to order continuous positive airway pressure (CPAP) supplies, and lists it under health care.

The front asks for your name, the last four digits of your Social Security number, whether your address is current or new, your address and an optional email address. The back, headed VA Denver Logistics Center, has a box for a resupply of your last PAP order and a checklist of individual supplies such as masks, cushions, hoses and filters. The form says resupplies are based on previously supplied items and the most updated prescription in your VA medical file.

VA's page says supplies can also be ordered online. You can fill out the PDF free in your browser on this page and download the result without an account.

Top of page 1 of VA Form VA2346b: Positive Airway Pressure (PAP) Devices and Supplies, as printed by VA

What's on VA Form VA2346b

Name and SSN

Your last name, first name and the last 4 of your Social Security number.

Address and email

Whether the address is current or new, then street or PO box, city, apartment, state and ZIP code, and an optional email address.

Full resupply box

One box to receive a resupply of your last PAP order. The form says this ensures up to a 12-month supply of your last order.

PAP supplies needed

Boxes for a mask with headgear and a replacement cushion (full, nasal, nasal pillow or oral interface), water chamber, hoses (tubing), mask liners, chinstrap, SD card, power cord and disposable or non-disposable filters.

Resupply note

The back is headed VA Denver Logistics Center, PO BOX 25166, Denver CO 80225, with a note that resupplies are based on previously supplied items and the most updated prescription in your VA medical file.

How to file VA Form VA2346b

  1. 1

    Enter your name and SSN

    Fill in your last name, first name and the last 4 of your Social Security number on the front.

  2. 2

    Confirm your address

    Mark whether the address is current or new, fill in the address and add an email address if you want to.

  3. 3

    Turn to the reverse side

    The front says: See Reverse Side to Order PAP Devices & Supplies.

  4. 4

    Choose a full resupply or single items

    Check the box for a resupply of your last PAP order, or check only the individual supplies needed.

  5. 5

    Send it or order online

    Send the form to the VA Denver Logistics Center address printed on the back, or order supplies online through VA's form page.

Why fill Form VA2346b on indox

You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.

  • Fill the form right in your browser, no software to install
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  • The official blank straight from the VA, not a copy someone retyped
  • Works on a phone, tablet or computer

Where to send it

Address on the form

The back of the form prints VA Denver Logistics Center, PO BOX 25166, Denver CO 80225.

Online

VA's form page says you can order supplies online instead of sending the paper form.

Items not listed

The form says: Please contact your Clinic for any items not listed above.

Edition

The form is dated JUL 2020, and VA's page lists a form revision date of July 2020.

Related forms

Who uses VA Form VA2346b?

  • People ordering CPAP supplies

    VA's form page says to use VA Form VA2346b to order continuous positive airway pressure (CPAP) supplies.

  • People reordering their last PAP order

    A checkbox requests a resupply of your last PAP order. The form says checking it will ensure up to a 12-month supply of your last order.

  • People needing only some items

    The PAP Supplies Needed list is, in the form's words, for individual supply request ONLY when an entire reorder is not necessary.

  • Prescription changes go through your provider

    The form says any additions or changes to your prescription are approved by your Provider, and to contact your Clinic for any items not listed.

  • Hearing aid batteries use a different form

    VA's page lists VA Form VA2346a, Request for Batteries and Accessories, to order hearing aid batteries and accessories.

VA's form page and the form itself describe who uses it.

Official sources and the blank

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Questions about Form VA2346b

What is VA Form VA2346b used for?

VA's form page says to use it to order continuous positive airway pressure (CPAP) supplies.

Can I order CPAP supplies online instead?

Yes. VA's form page says you can order supplies online instead of sending the paper form.

What does the resupply box do?

The form says checking it requests a resupply of your last PAP order and will ensure up to a 12-month supply of that order.

What decides which supplies are sent?

The form says resupplies are based on previously supplied items and the most updated prescription in your VA medical file, and that additions or changes to the prescription are approved by your Provider.

What if the item I need is not on the list?

The form says: Please contact your Clinic for any items not listed above.

Which form is for hearing aid batteries?

VA's page lists VA Form VA2346a, Request for Batteries and Accessories, to order hearing aid batteries and accessories.