One form for all therapies, all provinces!

Make a Referral

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:

 

Kinlogix Med Access Medesync PS Suite Wolf
Quebec Alberta Quebec Alberta Alberta
  Ontario   New Brunswick
 

Saskatchewan   Nova Scotia  
      Saskatchewan  

 

 

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