Fill out all information below and agree to Rental/lease agreement for your POC, Any questions call 512-905-5231
Checklist to Getting Your Portable Oxygen Concentrator
Required Fields *
When taking on Airline, Make Sure You Have Airline Required Documents For Your Flight
(Each Airline Has Their Own Requirements, Contact Your Airline)
Required Fields *
When taking on Airline, Make Sure You Have Airline Required Documents For Your Flight
(Each Airline Has Their Own Requirements, Contact Your Airline)
- Contact for Equipment
- Choose Model
- Extra Batteries
- Rental Period or Purchase
- Dates Needed
- Date of Birth
- Person Using Equipment
- Rental Agreement
- Delivery Option for Equipment
- Return Option for Equipment
- Prescription
- How You Would Like to be Contacted