HBOT Portal

HBOT Forms & Referral

Prepare for your Hyperbaric Oxygen Therapy session by downloading and printing the required clinical forms.

HBOT Patient Referral Form

Official physician referral form required for Hyperbaric Oxygen Therapy.

Digital Safety & Liability Consent Form

Complete and sign your clinical consent and contraindication screening online.

đź‘Ť Ready to Move Forward?

Take a quick look through this clinical screening checklist. If everything looks good and you’d like to proceed with hyperbaric oxygen therapy (HBOT), you’re ready to schedule your first session!

✅ You’re Good to Go If You:

  • • Don’t have a collapsed lung (pneumothorax)
  • • Aren’t having an asthma attack or ongoing lung issues like COPD
  • • Don’t have a high fever or a recent history of seizures
  • •
    Have healthy ears and sinuses — meaning:
    • Your ears can “pop” normally (equalize middle ear pressure)
    • You’re not dealing with ongoing ear or sinus infections
    • You haven’t had recent surgery or radiation to your head or neck
  • • Have never had major chest or lung surgery
  • • Don’t have severe heart failure
  • • Aren’t pregnant (unless you’ve already consulted with your doctor)
  • •
    Don’t have implanted devices like:
    • A defibrillator
    • A spinal pain pump
  • • Don’t have a known hole between the middle and inner ear (perilymph fistula)
  • • Don’t have unexplained spots or nodules on a chest X-ray

Note for Providers: Completed physician referral forms can be securely faxed directly to the clinic at 1-877-560-7779, or emailed to [email protected].

Ready to accelerate your cellular healing?

Skip the trial-and-error. Schedule your 15–30 minute consultation with our clinical team to map out your personalized recovery plan.