INOmax® Cylinder Orders / Collections – INOmax

INOmax® Cylinder Orders / Collections

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INOmax Cylinder Orders/Collections

For to order new cylinders and collection of empty cyclinders.

"*" indicates required fields

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This field is for validation purposes and should be left unchanged.

Account status

First Name*

Last Name*

Email*

Phone*

Specialty

Hospital Name*

Hospital Department*

Address 1*

Address 2

City*

State*

Postcode*

Customer PO Number:

INOmax cylinders required

Cylinder identification: this image may help to correctly identify the cylinder(s) required. If you have any questions, please contact us

As they are scheduled medicines, cylinder ordering for Size 88 and Size D cylinders is restricted in QLD to validated healthcare professionals (HCP). To have your account validated as a HCP, please add your APHRA number in your account profile. It will take 1-2 days for your account to be approved to order medicinal products.

INOmax® (nitric oxide) BOM-0137, Size 88, 800PPM – Schedule 4 Medicine

Please enter a number from 0 to 100.

INOmax® (nitric oxide) BOM-0138, Size D, 800PPM – Schedule 4 Medicine (transport only)

Please enter a number from 0 to 100.

Calibration Gas Nitric Oxide (BOMCOM0159) (45ppm)

Please enter a number from 0 to 100.

Calibration Gas Nitrogen Dioxide (BOMCOM0167) (10ppm)

Please enter a number from 0 to 100.

INOMAX cylinders to collect

Size 88 (BOM0137)

Please enter a number from 0 to 100.

Enter Size 88 cylinder serial number(s)

Size D (BOM0138) (transport only)

Please enter a number from 0 to 100.

Enter Size D cylinder serial number(s)

Calibration Gas Nitric Oxide (BOMCOM0159)(45ppm)

Please enter a number from 0 to 100.

Enter Nitric Oxide (45ppm) cylinder serial number(s)

Calibration Gas Nitrogen Dioxide (BOMCOM0167) (10ppm)

Please enter a number from 0 to 100.

Enter Nitrogen Dioxide (10ppm) cylinder serial number(s)

Emergency / Same Day Request

This is an emergency order / same day request. Please only select this option if cylinders are required on the same day.

Special Delivery Instructions

Schedule 4 Consent*

By ticking this box you are acknowledging that Medicines are being ordered by and supplied to a person or entity appropriately authorized under the relevant state legislation, and associated regulation to possess and use Schedule 4 Medicines

Order Status

SmartWays Order Status

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Delivery Date

Consignment Note

Packing Slip

Proof of Delivery

Receiver

Receiver Signature

* indicates mandatory fields

Note: Orders placed before 1pm will be dispatched on the same business day.
Orders placed after 1pm will be dispatched on the following business day.
Orders and deliveries are subject to National and State public holidays.