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BC HR2894: Orthoses Request and Justification

BC's Ministry of Social Development and Poverty Reduction uses HR2894 to pre-authorize orthoses, such as custom foot orthotics and knee braces, for people on income or disability assistance. A medical or nurse practitioner recommends the orthosis, then an orthotic or rehabilitation professional assesses the client and attaches a detailed quote. The program aims to fund the most basic, least costly orthosis that meets a medically essential need.

Who completes it

A medical practitioner or nurse practitioner completes Section 2, and an orthotist, pedorthist, podiatrist, occupational therapist or physical therapist completes the Section 3 assessment. The client completes Section 1, lists any other coverage and signs the consent.

Submitting and payment

How to submit it
The completed form, with the detailed quote attached to Section 3, goes to the ministry's Health Assistance office by fax or mail, using the details printed on page 2.
Who pays
HR2894 lists no fee for the practitioner or the assessor; the ministry's decision is about funding the orthosis itself, priced from the quote attached to Section 3.

Good to know

  • If Section 2 says a custom-made orthosis is required, the form tells the practitioner to refer the patient to an orthotist, pedorthist, podiatrist, occupational therapist or physical therapist.
  • For a knee brace, Section 2 asks whether it will be needed at least 6 hours per day, and Section 3 asks for the brace's make and model.
  • Section 3 asks whether the orthosis prevents surgery, supports post-surgical treatment, helps healing from surgery, injury or disease, or improves function impaired by a neuro-musculo-skeletal condition.
  • In Section 1 the client lists other resources that could pay, such as ICBC, WorkSafeBC, Veterans Affairs or private insurance, and confirms they agree with the recommended orthosis.

Get the official form

Download the current version from the source each time; forms change without notice.

Orthoses Request and Justification

Official pagePDF

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If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

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Frequently asked questions

Who can sign Section 2 of HR2894?

Section 2 is the Medical or Nurse Practitioner Recommendation, so a medical practitioner or nurse practitioner signs it and adds their position, professional registration number and contact details. They describe the patient's medical condition, name the type of orthosis recommended and say whether a custom-made orthosis is required.

Does HR2894 need a quote?

Yes. Section 3 carries the instruction to attach a detailed quote. The assessor also lists the specifications of the orthosis, explains how it will help joint motion or support, and can add other relevant information, such as the condition of the client's current device.

Where are the eligibility rules for HR2894?

The form refers to the BC Employment and Assistance Policy and Procedure Manual for the full eligibility criteria. The ministry's forms master list describes HR2894 as the form orthotic and bracing suppliers use to request pre-authorization, which is why the assessment section asks for product specifications and a quote.