Complaints Form

      Re-Ordering Oxygen Cylinders, Liquid Oxygen or Consumables

      To request replacement oxygen cylinders, cannula, mask or consumables, please complete the form below:

      Do you or anyone in your household have cold or flu symptoms?

      If you are requesting a cylinder delivery you can chose a day for your delivery.

      Monday-Friday for North West patients or seven days a week in other areas.

      Please let us know your requirements:

      B10 Large Static Cylinder

      B10 large static cylinder

      Standard Ambulatory Cylinder

      Standard ambulatory cylinder

      Smaller Ambulatory Cylinder

      Smaller ambulatory cylinder
      (only available after a professional medical assessment)

      Liquid Oxygen Dewar

      Liquid oxygen dewar

      Adult Cannula (Curved)
      Adult Cannula (Straight)
      Adult Mask
      Ear Protectors
      Paediatric Cannula
      Paediatric Mask
      Filter for Oxygen Machine
      Tender Grips

      Any other comments

      *required fields

        How can we help you?

        Please use the area below to submit your enquiry. It will then be passed on to the relevant contact person for a response.