Join our directory (US)

Join our directory (US)

Please note: New additions may take up to 2 weeks to process. Thank you for your patience.

By submitting this form, you consent to Fisher & Paykel Healthcare processing and storing the information provided. Your information will be stored securely by Fisher & Paykel Healthcare Limited based in New Zealand and may be shared internally with other Fisher & Paykel Healthcare group entities. We will not share, disclose or sell your information to third parties for marketing purposes. For more information please see our Global Privacy Statement.

How do you sell our products?

Via an online store

Via physical store(s)

Business Name*

Contact Phone Number (for customer enquiries)*

Phone

Email Address (for general customer enquiries)*

Please enter your web page URL showing Fisher & Paykel Healthcare's product range

See example here.

URL or website page address.

Please upload your Business Logo for inclusion on the Dealer Directory

Requirements:

Format: JPG/JPEG/PNG
Maximum file size: 1 MB
Aspect ratio: 4:3 (recommended)

Drag and drop files here or

Which of our products do you sell online?*

Please provide the product page URLs for the products you've selected below.

These should be the pages where patients can purchase your products online. See an example of a product page here.

F&P Nova Micro

F&P Solo Pillows

F&P Solo Nasal

F&P Evora Full

F&P Evora Nasal

F&P Brevida

F&P Vitera

F&P Eson 2

F&P Simplus

How many CPAP clinic/store locations do you have?*

Please Note:

a. This form will need to be completed for each store location, up to a maximum of 7 physical stores.

b. If you have more than 7 physical stores, please enter the details for the first 7 stores below, submit, and repeat the process as needed.

c. As only authorized Fisher & Paykel Healthcare Providers are represented on our Dealer Directory, please list ONLY those stores that:

Have an Account and purchase directly from Fisher & Paykel Healthcare (i.e. Affiliates should not be included).
Are open at least 5 days per week, from 9:00am to 5:00pm daily.

Store 1*

(Store Name) *

(Street Address Line 1)*

(Street Address Line 2)

(City)*

(State)*

(Postcode)*

(Contact Phone Number)*

Phone

(Email Address)*

Store 2*

(Store Name) *

(Street Address Line 1)*

(Street Address Line 2)

(City)*

(State)*

(Postcode)*

(Contact Phone Number)*

Phone

(Email Address)*

Store 3*

(Store Name) *

(Street Address Line 1)*

(Street Address Line 2)

(City)*

(State)*

(Postcode)*

(Contact Phone Number)*

Phone

(Email Address)*

Store 4*

(Store Name) *

(Street Address Line 1)*

(Street Address Line 2)

(City)*

(State)*

(Postcode)*

(Contact Phone Number)*

Phone

(Email Address)*

Store 5*

(Store Name) *

(Street Address Line 1)*

(Street Address Line 2)

(City)*

(State)*

(Postcode)*

(Contact Phone Number)*

Phone

(Email Address)*

Store 6*

(Store Name) *

(Street Address Line 1)*

(Street Address Line 2)

(City)*

(State)*

(Postcode)*

(Contact Phone Number)*

Phone

(Email Address)*

Store 7*

(Store Name) *

(Street Address Line 1)*

(Street Address Line 2)

(City)*

(State)*

(Postcode)*

(Contact Phone Number)*

Phone

(Email Address)*

I consent to Fisher & Paykel Healthcare keeping me informed about new F&P products, clinical updates, events and promotions on Obstructive Sleep Apnea Care.

Yes

Please provide an email address that you would like Fisher & Paykel Healthcare to send this information to.

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