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BC Form HR3727: Breathing Device Request (CPAP, BiPAP)

B.C.'s Ministry of Social Development and Poverty Reduction uses this two-page form to fund the least expensive, most appropriate breathing device for income or disability assistance clients, or for people with a life-threatening health need. It covers CPAP and BiPAP trials and buyouts, mandibular advancement devices, supplies, percussors, cough assist devices, nebulizers, humidifiers and suction machines. The ministry must approve requests before purchase.

Who completes it

A medical practitioner or nurse practitioner completes Section 2 (medical condition and recommended device) or attaches a written prescription; a respiratory therapist completes Section 3 with specifications, a functional assessment and a detailed quote. The client completes and signs Section 1.

Submitting and payment

How to submit it
Fax the completed form and required documents to the ministry using the number printed on the form; ministry policy also allows submission in person or by mail.

Good to know

  • A CPAP or BiPAP trial needs Sections 1 to 3, diagnostic sleep tests and a supplier quote; a buyout needs a therapeutic sleep test, a compliance report and a buyout quote.
  • Mandibular advancement devices are considered only for people intolerant of positive airway pressure devices, and need diagnostic sleep tests and a quote from a dental supplier.
  • For a life-threatening health need, financial eligibility must be established first through My Self Serve; the form also asks about other resources such as ICBC, WorkSafeBC, NIHB or private insurance.
  • Positive airway pressure devices and most other breathing devices are replaced every 5 years and supplies yearly, unless a change in medical condition requires earlier replacement.

Get the official form

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

Breathing Device Request and Justification

Official pagePDF

Fill it with Vero

Upload the fillable PDF 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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How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.

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Frequently asked questions

Who signs the BC breathing device request?

For most devices, three people: the client signs Section 1, a medical practitioner or nurse practitioner completes Section 2 or attaches a prescription, and a respiratory therapist completes Section 3. Supplies need only Section 1 and a quote, and percussors can use an occupational or physical therapist's written assessment instead.

Does the BC ministry cover CPAP for sleep apnea?

The ministry may cover a CPAP or BiPAP device when it is medically essential for moderate to severe obstructive sleep apnea, prescribed by a medical practitioner or nurse practitioner and confirmed by a respiratory therapist. Ventilators are not eligible, and the device must be the least expensive appropriate option.