Ordering from Air Liquide
Please download the order form as required for the therapy and service that you require.
Please ensure to provide as much detail as possible regarding the contact details of the patient and any carers that are involved and wish to be present at the installation of equipment.
If you have any concerns regarding the safe use of your prescribed equipment please don't hesitate to pick up the phone to us and discuss this further.
If you would like to discuss any further options regarding the delivery and effective use of our therapies please feel free to contact the commercial department to speak to one of our nurses or commercial team members.
If the patient has a Medical Card please ensure to send this to their local PCCC (Primary Community and Continuing Care) for processing. If you are unsure which area to send this to please feel free to contact our Customer service team.
Oxygen Order formDownload the document PDF (678.15 KB)
NIV Order FormDownload the document PDF (78.69 KB)
Airvo 2 Order formDownload the document PDF (187.88 KB)
CPAP Order FormDownload the document PDF (71.29 KB)
Cough Assist Order FormDownload the document PDF (342 KB)
Sleep study request formDownload the document PDF (45.28 KB)
Nebuliser Order FormDownload the document PDF (40.67 KB)
BiPAP Auto ST order formDownload the document PDF (66.27 KB)
Trilogy 100 Order formDownload the document PDF (105.25 KB)
Fisher & Paykel myAirvo 2 prescription settings
When prescribing the Airvo 2 or myAirvotm for home use please refer to the below chart* as a guide to the quantity of oxygen required to achieve % of oxygen delivered to your patient.
Home oxygen is delivered via a home oxygen concentrator. The maximum delivery of oxygen at home is 18 LPM** delivered directly to the inlet of the Airvo device
*Please note that this is for guidance purposes only and achieved % percentage deliveries of oxygen will vary depending on devices used and conditions of use.
**Oxygen delivered though normal / high flow oxygen cannula and venturi mask is limited to 15 LPM
HST (Home Sleep Tests) can be carried out on request
Our Patient care specialist will arrange a time that suits the patient to visit the home and demonstrate the operation of the equipment
Full training will be given to ensure an accurate and efficient sleep study is carried out at home for the patient.
Raw sleep study data is then sent to our independant sleep physiologist who scores the study to Irish Sleep Society guidelines and returns the scored sleep study to the prescribing physician.
Please do not hesitate to contact us if you have any questions.
Only urgent calls are accepted outside these hours