Oxygen Request Form for Travellers #2

Oxygen Request Form for Travellers

Here you can request a non-binding quotation for oxygen services abroad.

Please provide as many details as possible – fields marked with (*) are required.

To provide feedback on our services use our Comments form.

For general queries please use our Contact form.

    • 1

      Your contact information

    • 2

      Your travel destination information

    • 3

      Your oxygen therapy

    • 4

      Oxygen equipment requested

    • 5

      Remarks and special requests

    • 6

      Submit form

    1/6

    Your contact information

    Your contact information

    Your travel destination information

    In the following countries a doctors prescription is required:
    - France + Corsica + Monaco
    - Ireland + United Kingdom
    - USA + Canada
    - Indonesia
    - Malta
    - Portugal
    - Ibiza
    - Cruises in Spain
    - Norway
    - Cyprus
    The list of countries is subject to change without notice.
    "Requested materials must match your prescribed oxygen therapy. In case the materials are not available at your destination OxygenWorldwide will propose alternative materials suitable to your oxygen therapy."

    IMPORTANT: (local contact person/airbnb bookings, etc.)
    OxygenWorldwide arranges the delivery of oxygen before you arrive and collects it again after you leave. To achieve this we will always need a verifiable local contact person who can accept the materials on your behalf. In the event that you do not have a local contact person because you made a booking through e.g. Airbnb and you have to let yourself in with a key or with a code, we can in only in some cases make a delivery on your arrival day or the day after.
    The materials will then be collected before you leave.
    Important: this last option is not available in all countries.

    If you are travelling to several locations please specify in "Your Remarks" below.

    What is your maximum oxygen usage in liters per minute and hours per day? (*)

    Liters per minute:

    Hours per day:

    If you have a variable or special oxygen therapy please specify in "Your Remarks" below.

     

    Type of oxygen equipment requested (*)





    Flowtype:

    If you have any special equipment requests please specify in "Your Remarks" below.

    How did you find our website?

    Your remarks / special requests:


    Address
    Apartado de Correos 421
    03590 Altea
    Alicante, Spain

    Telephone

    +34 96 688 28 73

    +34 609 657 727
    (only in case of emergency)

    Information
    info@oxygenworldwide.com

    OXYGEN for my holiday

    You can request a non-binding quotation for oxygen services abroad.

    EHIC Scheme

    We have started a special service for the initial set-up of the medical oxygen at your destination to give you peace of mind.

    Read our blog

    Find out all the news and updates about travelling with oxygen.

    by Pilar Vidueira

    Oxygen Request Form for Travellers

    Oxygen Request Form for Travellers

    Here you can request a non-binding quotation for oxygen services abroad.

    Please provide as many details as possible – fields marked with (*) are required.

    To provide feedback on our services use our Comments form.

    For general queries please use our Contact form.

      Your contact information

      Your travel destination information

      In the following countries a doctors prescription is required:
      - France + Corsica + Monaco
      - Ireland + United Kingdom
      - USA + Canada
      - Indonesia
      - Malta
      - Portugal
      - Ibiza
      - Cruises in Spain
      - Norway
      - Cyprus
      The list of countries is subject to change without notice.
      "Requested materials must match your prescribed oxygen therapy. In case the materials are not available at your destination OxygenWorldwide will propose alternative materials suitable to your oxygen therapy."

      IMPORTANT: (local contact person/airbnb bookings, etc.)
      OxygenWorldwide arranges the delivery of oxygen before you arrive and collects it again after you leave. To achieve this we will always need a verifiable local contact person who can accept the materials on your behalf. In the event that you do not have a local contact person because you made a booking through e.g. Airbnb and you have to let yourself in with a key or with a code, we can in only in some cases make a delivery on your arrival day or the day after.
      The materials will then be collected before you leave.
      Important: this last option is not available in all countries.

      If you are travelling to several locations please specify in "Your Remarks" below.

      What is your maximum oxygen usage in liters per minute and hours per day? (*)

      Liters per minute:

      Hours per day:

      If you have a variable or special oxygen therapy please specify in "Your Remarks" below.

      Type of oxygen equipment requested (*)





      Flowtype:

      If you have any special equipment requests please specify in "Your Remarks" below.

      How did you find our website?

      Your remarks / special requests:


      Address
      Apartado de Correos 421
      03590 Altea
      Alicante, Spain

      Telephone

      +34 96 688 28 73

      +34 609 657 727
      (only in case of emergency)

      Information
      info@oxygenworldwide.com

      OXYGEN for my holiday

      You can request a non-binding quotation for oxygen services abroad.

      EHIC Scheme

      We have started a special service for the initial set-up of the medical oxygen at your destination to give you peace of mind.

      Read our blog

      Find out all the news and updates about travelling with oxygen.

      by Pilar Vidueira

      Comments

      Your Comments

      The secret of better services is in your comments.
      Dear client, we would like to thank you for your valuable considerations with helpful criticism about OxygenWorldwide services. For the improvement of our services, we would like you to fill out this questionnaire. Thank you for joining us.

        Telephone service:

        Friendliness:

        Efficiency in service:

        Technical standard of supplied equipment:

        Price:

        Would you consider using our service again?

        Would you recommend us?

        How did you know about us?


        Address
        Apartado de Correos 421
        03590 Altea
        Alicante, Spain

        Telephone

        +34 96 688 28 73

        +34 609 657 727
        (only in case of emergency)

        Information
        info@oxygenworldwide.com

        OXYGEN for my holiday

        You can request a non-binding quotation for oxygen services abroad.

        EHIC Scheme

        We have started a special service for the initial set-up of the medical oxygen at your destination to give you peace of mind.

        Read our blog

        Find out all the news and updates about travelling with oxygen.

        by Pilar Vidueira

        General Enquiry

        Contact

        Please use this form for a general enquiry.

        To provide feedback on our services use our Comments form.

        To request oxygen use our Oxygen Request form.

          How did you find our website?


          Address
          Apartado de Correos 421
          03590 Altea
          Alicante, Spain

          Telephone

          +34 96 688 28 73

          +34 609 657 727
          (only in case of emergency)

          Information
          info@oxygenworldwide.com

          OXYGEN for my holiday

          You can request a non-binding quotation for oxygen services abroad.

          EHIC Scheme

          We have started a special service for the initial set-up of the medical oxygen at your destination to give you peace of mind.

          Read our blog

          Find out all the news and updates about travelling with oxygen.

          by Pilar Vidueira