Rental Form Thank You

Thank You!

Your submission has been received.

Thank you for submitting your rental details. A Rental Specialist will call you within 1 hour to finalize your order. If it is urgent, please call (888) 235-0623.

In the meantime, we require a copy of your prescription from a doctor showing a need for oxygen. You can fax the prescription to 1-888-960-0441 Attention: Jack. You can also email your prescription to [email protected]. You will be contacted within 1 hour to have your order finalized. Thanks again!