Schedule Oxygen Rental

PLEASE NOTE: THIS FORM IS TO SCHEDULE OXYGEN RENTAL FOR ALTITUDE SICKNESS PREVENTION ONLY.

IF YOU ARE ALREADY SUFFERING WITH SYMPTOMS OF ALTITUDE SICKNESS, PLEASE CALL 970-389-7999 TO SPEAK WITH A MEDICAL PROVIDER REGARDING A HOUSE CALL VISIT.

Name

First NameLast Name

Email

Phone Number

Format: (000) 000-0000.

Please select date and APPROXIMATE time for delivery.

You can also CALL 970-389-7999 to schedule a rental or with any questions.

Please call 970-389-7999 to coordinate the time for delivery on the day of rental.

If you need delivery between the hours of 8pm to 8am, please CALL 970-389-7999.

START rental and approximate time

END rental and approximate time

If your rental drop off or pick up day is unavailable, please call us at 970-389-7999 for more options for medical grade oxygen.

We strongly recommend against the use of recreational oxygen rentals (any that do not require a prescription) as we see many of their customers as patients suffering from altitude sickness.

Once you click SUBMIT, you will be redirected to our consent and intake form which must be completed to hold your rental concentrator.