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!

Send Us Your Prescription

Upload Your Prescription

For the quickest turn around give us your name and upload an image or PDF of your prescription right here. Our team will have access to it right away. We will not charge your card or ship your order until we receive a valid prescription.

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