Training Requirement to Purchase TxO2
Note - Use this section if...This page MUST be completed, prior to ordering your TXO2 Oxygen Unit.
This must be done in order to comply with FDA regulations.
Please select 1 of the 3 options below and fill in your name and date
.
We cannot respond to your order without completion of 1 of the sections below.
THANK YOU.

Each TXO2 Model Order Page has a copy of this Training Affidavit.

Please complete the pertaining section of this form as instructed below.
"
IMPORTANT - PRINT THIS PAGE
FOR YOUR RECORDS"

1.) Type in your name and date.

2.) Before pressing the SUBMIT Button located below, please print a copy of this page for your records.
(You may need a copy of this form to refill your unit, depending on where the unit is refilled).

3.) Once you have printed a copy of the completed form for your records, please use the submit button provided at the bottom of this page to send us a copy of this form. We must have this submitted form for our records, in order to respond to your order request.

Note - Use this section if...If you wish to purchase an empty unit,
please disregard the options and submit section of this page.
The empty unit has no FDA training requirements in order to ship.

Please Dial: 1.800.GET.TXO2
to order direct.
(1.800.438.8962)


OPTION 1
Note - Use this section if...If you have NEVER had FORMAL first aid oxygen TRAINING, OR
have not had formal training within the past 2 years, please use this section of the form.
"REMINDER - PRINT THIS PAGE FOR YOUR RECORDS"

Please review the following LINK >> TxO2 “BrainSaver” Training Syllabus
AND
21 Common Questions About Emergency Oxygen > 21 FAQs Questions/Answers

First & Last Name - No Formal Training:

Date:


OPTION 2
Note - Use this section if...If you are a licensed healthcare professional and oxygen administration
is a normal part of your practice, OR if you have had Formal First Aid Oxygen Training
within the past 2 years, please use this section of the form.
"REMINDER - PRINT THIS PAGE FOR YOUR RECORDS"

First & Last Name - Licensed Healthcare Professional OR Formal First Aid Oxygen Training within the past 2 years

Date:


OPTION 3
Note - Use this section if...If you are purchasing the TXO2 Oxygen Unit to ship to another party (eg: Gift, donation, etc.) Please use this section of the form.
"REMINDER - PRINT THIS PAGE FOR YOUR RECORDS"

First & Last Name - Purchasing for another party:

Date:



On the actual TXO2 Model Order Page, you will have a Submit Button,
in order to place a request to order your TXO2 Unit.


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