Fax Oxygen Prescription - RANA Respiratory Care Group 2025

Get Form
oxygen prescription example Preview on Page 1

Here's how it works

01. Edit your oxygen prescription example online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send home oxygen prescription example via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out Fax Oxygen Prescription - RANA Respiratory Care Group with DocHub

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2
  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering the recipient's details in the 'To' and 'Fax' fields. Ensure accuracy for timely processing.
  3. Fill in the date of the prescription using the provided format (DD/MM/YYYY). This is crucial for tracking validity.
  4. In the 'Referring Physician Authorization' section, print or affix your clinic label, including your name, clinic name, phone number, and address.
  5. Complete the patient information fields: Patient Name, Birth Date (DD/MM/YYYY), Address, Health Services Number, and Phone.
  6. Specify oxygen therapy requirements by filling in LPM (liters per minute) and hours per day. Also, indicate desired SpO2 levels.
  7. Add any additional notes relevant to the patient's care in the designated section.
  8. Finally, ensure that you sign and date the form at the bottom before submitting it.

Start using our platform today to streamline your document editing and submission process for free!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
Contact us

If you often work with documents stored in your Google Drive, DocHub is a perfect solution for you to easily and quickly fill out, modify, and sign them. This editor integrates well with Google services, so you can export your oxygen concentrator prescription example from your Google Drive to the editor without downloading and re-uploading it. Right-click on your document, choose Open With → DocHub PDF Sign and Edit. In our editor, add and assign Signature Fields for all people involved, then click on the Menu option above → Send → choose how you want to share your paperwork.

Document editing with DocHub is equally convenient on desktop and mobile devices. You just need an internet browser to modify your oxygen order example on Android. Open our site and sign in to access the instruments you need. Add your document and introduce your intended modifications. Next, you can keep your form in your document storage or send it out instantly.

And, if you qualify, our telehealth partner will write you a prescription for oxygen and send a digital copy directly to us no muss, no fuss!
Your prescription should include this information: A diagnosis, which should explain why you require oxygen therapy. Information about the flow dosing (continuous versus pulse dose) Information regarding recommended oxygen dosage (liters per minute for continuous flow or milliliters per breath for pulse dose)
Order Indicating the Following: Diagnosis. Duration. Flow Rates. Stationary Flow System. Standard Concentrator. Portable Flow System. Compressed Gas. Liquid Oxygen. Portable Oxygen Concentrator. Length of Need. Indication if oxygen will be used with PAP.
be ready to get more

Complete this form in 5 minutes or less

Get form

People also ask

Indication. Oxygen is indicated for hypoxaemia, not breathlessness. Aim for oxygen saturations of 94-98%, or 88-92% in those at risk of type 2 respiratory failure. The British Thoracic Society (BTS) recommends clinical assessment if the oxygen saturation falls 3% below the patients target.
Plus, an oxygen prescription ensures that you know exactly how much oxygen to use, and when to use it, so that you are using your medical oxygen correctly for your unique needs. A prescription helps ensure that you use your medical oxygen only as directed.
Physician (medical doctor, doctor of osteopathy, or doctor of pediatric medicine) Nurse practitioner (NP) Clinical nurse specialist (CNS) Physician assistant (PA)
Yes, you need a prescription from a healthcare provider to get an oxygen tank.
A physicians prescription for oxygen services should indicate a specific liter flow; however, a range (for example, O2 @ 24 liters per minute) is acceptable if the prescription also indicates that a certain blood saturation level must be maintained during unstable periods.

oxygen prescription form