Make a Referral
One form for all therapies, all provinces!
Medigas invites physicians and nurse practitioners to use its Respiratory Referral/Requisition of Services form to refer your patients in need of Home Oxygen, PAP or other Respiratory Therapy. One form for all therapies, all provinces!
Simply complete this form (by computer or by hand) and fax to our national toll-free fax number, 1-855-233-1160 during normal business hours, Monday-Friday. For after-hours service, please call Medigas at 1-866-446-6302.
For your convenience, this Medigas Respiratory Referral/Requisition of Services is loaded as a form template in the following TELUS® EMR platforms: