HBOT Request Form
Client and Patient Information
HBOT requirements:
All HBOT requests require a copy of the most recent patient records, a COMPLETE list of current health conditions and ANY current medications including any topicals, ear/eye meds, oral medications, etc.
The requesting doctor must also review the HBOT Contraindications List to ensure the patient is likely a good candidate for treatment. Any questions can be directed to the HBOT doctors at VNIOC (Dr. Rybak or Dr. McDonnell).
Please send relevant patient records to questions@vnioc.com.
A member of the HBOT team may contact the requesting doctor if any questions or concerns arise about the case being referred. We will make every effort to treat the patient as quickly as possible, as our schedule allows. In cases where multiple treatments are recommended, the HBOT team will relay this information to the requesting doctor and/or client as needed. Prior to treatment, the client must fill out an HBOT-specific patient questionnaire as well as an HBOT-specific release form.