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Accreditation

Below you will find links to the required information and application process for Home Oxygen Therapy in the Vancouver Island Health Authority Home Oxygen Program (HOP). As a physician or clinician acting on behalf of the prescribing physician it will be required that the client whom the Rx is for must undergo an Arterial Blood Gas (ABG) for approval. If you have not already begun this process we recommend that it be started immediately, so there is no delay in funding. The ABG cannot be any older than 48 hours when submitting the HOP application for approval.

After completing this form or faxing in the Rx request the client will be contacted and informed of the process. We will begin the application process and submit these to the physician office for completion.

If you have any questions regarding the approval process please do not hesitate to email us or contact our offices. Our client services department will be happy to be of service. Presently Beverley Shaw is our client implementation specialist.

Fill out this form and click Submit. All of the fields are required. Telephone Number, Personal Health Number, and Email Address must have correct format. See the examples below.

Telephone Number: 250-234-5678
Personal Health Number: 123 456 7890
Email Address: sample@domain.com

Client Full Name:
Location / City:
Telephone Number:
Personal Health Number:

Physician Full Name:
Telephone Number:

Type the details of the New Rx below.

Sender Email Address:
Confirm Email Address: