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(Addressograph / Label i(FIF available)available)WESTERN AUSTRALIAN DOMICILIARY OXYGEN REFERRAL FORMREFERRAL to: Silver Chain SACHS Residential Resection 1: PATIENT DETAILS Patient Name:Patient Contact
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How to fill out western australian domiciliary oxygen

01
Contact your healthcare provider to determine if you qualify for domiciliary oxygen.
02
Obtain a prescription for domiciliary oxygen from your healthcare provider.
03
Contact an oxygen supply company in Western Australia to set up the delivery of the oxygen equipment.
04
Fill out any necessary forms provided by the oxygen supply company, including information about your medical condition and oxygen needs.
05
Schedule a time for the oxygen equipment to be delivered to your home.
06
Follow the instructions provided by the oxygen supply company on how to use and maintain the equipment.

Who needs western australian domiciliary oxygen?

01
Individuals with chronic respiratory conditions such as COPD, emphysema, or pulmonary fibrosis may need domiciliary oxygen to help maintain adequate oxygen levels in their blood.
02
Patients who experience difficulty breathing or low oxygen saturation levels may also benefit from domiciliary oxygen therapy.
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Western Australian domiciliary oxygen refers to a program that provides oxygen therapy to patients with chronic respiratory conditions in their homes, supporting their health and well-being.
Healthcare providers, such as doctors and respiratory specialists, who prescribe domiciliary oxygen therapy for patients are required to file the necessary documentation.
To fill out the forms for western australian domiciliary oxygen, ensure you provide accurate patient details, prescription information, and any required medical history as specified in the guidelines.
The purpose of western australian domiciliary oxygen is to improve the quality of life for patients with respiratory issues by ensuring they have access to oxygen therapy at home to manage their conditions effectively.
The reporting must include patient identification, prescribed flow rate, duration of therapy, clinical necessity, and physician details.
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