Application forms
Oxygen Cylinder Refill Request Form (OCRR)
Important notes:
- Customers with more than 6 cylinders will have their cylinders refilled within 24 hours at a special price.
- No Afrox cylinder may be considered for swop, refill, whatsoever.
- Swop once off is done only when both the vendor and customer agree to surrender their cylinder.
- Swop and Swop back: The swop back must be done within 30 days from the first day of swop; the customer is liable for the payments of both transactions.
- Refill only: may take up to 5 working days depending on the number of cylinders that must be refilled.
Oxygen Machine/ Concentrator Rental Form (OCRF)
Important notes:
- 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).
- 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.
- The customer may negotiate rental for a shorter period (one or two months).
- 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).