Medigas Online Forms - Medigas Manitoba

Medigas Online Forms

The following online forms are created in Adobe Acrobat Reader. You can complete them electronically.

If you do not have Adobe Acrobat Reader installed on your electronic device, please click here to download a free version.

REORDER FORM

If you would like to receive reorder reminders, please download and complete the reorder reminder form electronically.

Submit the completed form to: cpap@medi-gas.com

EPWORTH SCALE AND SAQLI FORMS

To help you with your sleep apnea or snoring, we require a better understanding of your daily activities, emotions, social interactions and symptoms.

At the request of your therapist, please download the required form(s) and complete each question electronically.

Submit the completed form(s) by:

  1. E-mail the completed form to forms@medi-gas.com.
  2. Hand delivery:
    1. Print the completed form and bring it to your next appointment, or
    2. Write down the “Total” number in the coloured box and bring it to your next appointment.
  3. E-mail (forms@medi-gas.com) or phone (1-855-766-7388) the “Total” number to Medigas.

If you have questions, please contact us by phone (1-855-766-7388), or e-mail (info@medi-gas.com).

CUSTOMER SATISFACTION SURVEY

We’d love to hear from you. To help us serve you better, and improve our business and products, please download and complete this short survey electronically.

Submit the completed survey to: cpap@medi-gas.com