Oxygen Machine/ Concentrator Rental Form (OCFR)

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Oxygen Machine/ Concentrator Rental Form (OCRF)

What do you need? (Check where applicable)

Oxygen flow required

Relationship with user (please select)

7 + 8 =

Important notes:

  1. The service is applicable to customers who reside in Gauteng. We reserve the right to provide /decline service to certain areas (distance may also be a factor).
  2. In case of unfortunate circumstance of death, the lease will be cancelled as soon as we are informed via email/ WhatsApp. In case of prolonged hospitalization, the customer may consider returning the machine to avoid paying the premium unnecessarily.
  3. The customer may negotiate rental for a shorter period (one or two months).
  4. We also offer an optional RENT-TO-BUY Lease for a period of 12 months. This is applicable to the machine MODEL CONTEC7L only (T’s & C’s apply).