Get Non-va Hospital Discharge Order Form For Home Oxygen ...

Filling out the Non-VA Hospital Discharge Order Form for Home Oxygen is a crucial step for ensuring a seamless transition from hospital to home care. This guide provides step-by-step instructions to help users complete the form accurately and efficiently.

Follow the steps to complete the form online.

1. Press the ‘Get Form’ button to obtain the form and open it in your preferred editing tool.
2. Fill in the patient's personal information, including the veteran's name, the last four digits of the Social Security Number, and the date of birth.
3. Provide the hospital room number and the anticipated discharge date.
4. Enter the name and contact number of the emergency contact.
5. Identify the name of the facility and the contact number of the case worker making the referral.
6. Fill out the hospital name and its contact information.
7. Indicate the diagnosis and the date of assessment.
8. Determine if the patient meets one of the three OVAMC qualifying criteria for oxygen. Record the relevant readings for resting SPO2 or PO2 as required.
9. If applicable, document the oxygen prescription details, including the flow rate, type of delivery method, and whether a portable system is required.
10. Ensure to fax the completed form along with all required documentation to the appropriate fax number specified above.
11. Attach copies of any relevant medical results such as ABG tests, overnight oximetry tests, sleep studies, or 6-minute walk tests.
12. Review the form for any missing information. Incomplete forms may delay processing of the oxygen therapy order, so ensure all sections are properly filled out.
13. Once all information is complete, save the changes, and download or print the form for your records.

Start completing the Non-VA Hospital Discharge Order Form for Home Oxygen online today to ensure timely care for your needs.