Important Information To Record - BONSAI VELOCITY OM-812 Product Information And Instructions

IMPORTANT INFORMATION TO RECORD

Your Name: ______________________________________________________________
Date You Received Your Unit:
Prescribed Oxygen Flow Setting:
• At Rest: ___________________________
• During Exercise: ___________________________
Home Care Provider's Name:
Home Care Provider's Phone Number:
Physician's Name: __________________________________________________________
Physician's Phone Number:
Notes: ________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________
_________________________________________________
(________)________________________________
(_______)_________________________________________
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