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Designed for authorised providers participating in the provincial program for compression bandages and garments, this form supports requests for payment, authorisation, or claim cancellation for medically necessary lymphoedema treatment. It captures patient identification, the affected limb or body region, requested compression aids, service dates, reimbursement details, and supporting clinical information required to process the claim. The form also records provider certification confirming that the prescribed compression products were supplied in accordance with the program requirements. Heidi helps clinicians and authorised providers efficiently generate structured documentation, reducing administrative workload while supporting accurate reimbursement requests and timely access to compression therapy for people living with lymphoedema.
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