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PMD Healthcare PMD Healthcare

Rx Request

Get a prescription.

To Enroll in Spiro PD WMS, you first need a prescription from your doctor.
Simply complete the form below to initiate your Spiro PD prescription.

Request for Spiro PD Personal Spirometer Prescription

This request will be forwarded to your doctor’s fax machine.


  • I, (Patient Name), a patient of (Doctor Name), am requesting a prescription for a home use, personal spirometer, Spiro PD, supplied by PMD Healthcare located in Allentown, PA.

    This request is being sent directly to your doctor’s fax machine.**