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  • Ak Tz-243 2012

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PHYSICIAN S CONSENT FORM For Portable Oxygen Concentrator (POC) use Must be completed in full by the passenger s physician and printed on physician s letterhead. If passenger is using a POC rental,.

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How to fill out the AK TZ-243 online

The AK TZ-243 is a physician’s consent form necessary for the use of a portable oxygen concentrator (POC) during travel. This guide will provide clear, step-by-step instructions to assist you in completing the form accurately and efficiently.

Follow the steps to successfully complete the AK TZ-243 form.

  1. Click ‘Get Form’ button to obtain the form and access it in the online editor.
  2. Enter the physician’s name in the designated field. This information is essential for verification purposes.
  3. Fill in the place of business and the complete address of the physician’s office to ensure proper communication.
  4. Provide the physician’s telephone number and fax number. This allows for any necessary follow-up communications.
  5. In the section related to the patient, write the full name of the passenger or patient who will be using the POC.
  6. Specify the maximum oxygen flow rate in liters per minute (LPM) that the device will deliver, considering the aircraft’s pressure conditions.
  7. Indicate the make and model of the portable oxygen concentrator to confirm it complies with airline regulations.
  8. Ensure the patient can operate the POC and respond to alarms. Mark 'Yes' or 'No' as appropriate.
  9. Circle all applicable options for when the patient will need to use the device: Taxi, Take-off, In flight, or Landing.
  10. Remind the patient to bring sufficient charged batteries, plus an extra for delays. The physician must initial this section.
  11. Complete the form with the physician’s signature and the date of signing. Ensure this is printed on official letterhead as required.
  12. After reviewing the completed form, users can save changes, download, print, or share the finalized document.

Complete your AK TZ-243 form online today for a smoother travel experience.

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AK TZ-243
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