Automated First Aid Oxygen Training & Sales

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Affirmation Form

AFFIRMATION by Student of Completion of the Lif-O-Gen® Automated Training Curriculum


Date training completed -

Name - attests to the following:

1.) I have viewed the Lif-O-Gen Automated 46-second Demonstration & Training video.

2.) I have read & UNDERSTAND the first 12 "Questions & Answers" of the Lif-O-Gen® Automated Training Curriculum.

3.) I have read the "Student Deployment Session" of the curriculum.

4.) I have performed an actual deployment & re-storage of a functioning Lif-O-Gen® Automated First Aid Oxygen unit.

Lif-O-Gen® Automated Unit used to complete 4.) above, purchased by OR owned by:

Date Unit Purchased if above applies -

Email: (Needed to receive your 24-month Certification)

Contact Phone: (Optional)

On receipt of the completed form, a 24-Month Certification document will be e-mailed back. This Certification is for your records & others who may need it for documentation.

Records will be maintained by

THANK YOU for participating in our Training Curriculum,
The Staff at
Automated Oxygen Training

~ Please click the Submit Button to send this form - Thank You ~


Lif-O-Gen® manufactured in USA by:
~ Allied Healthcare Products Inc.
St Louis, MO ~
Allied manufactures critical care respiratory support equipment, eg: ventilators.

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