FORM 4
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934,
Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f)
of the Investment Company Act of 1940.
[ ] Check box if no longer subject of Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
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1. NAME AND ADDRESS OF REPORTING PERSON:
Christensen Que H.
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(Last) (First) (Middle)
10093 South 2165 East
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(Street)
Sandy Utah 84092
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(City) (State) (Zip)
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2. ISSUER NAME AND TICKER OR TRADING SYMBOL
Interwest Home Medical, Inc. - IWHM
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3. IRS OR SOCIAL SECURITY NUMBER OF REPORTING PERSON (Voluntary)
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4. Statement for Month/Year
January, 2000
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5. If Amendment, Date of Original (Month/Year)
N/A
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6. RELATIONSHIP OF REPORTING PERSON(S) TO ISSUER - Check all applicable
_____ Director _____ 10% Owner
__X__ Officer (give title _____ Other (specify below)
below)
Vice-President/COO
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TABLE 1 - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
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1. Title of Security (Instr. 3)
Interwest Home Medical, Inc. - Common Stock
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2 Transaction Date - (Month/Day/Year)
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3. Transaction Code - (Instr. 8)
Code V
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4. Secutities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
Amount (A) or (D) Price
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5. Amount of Securities, Beneficially Owned at End of Month
(Instr. 3 and 4)
113,886
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6. Ownership Form - Direct (D) or Indirect (I) - (Instr. 4)
D
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7. Nature of Indirect Beneficial Ownership - (Instr. 4)
N/A
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TABLE II - DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(e.g. puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security - (Instr. 3)
Stock Option - Right to Buy
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2. Converstion or Exervice Price of Derivative Security
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3. Transaction Date - (Momth/Day/Year)
January 5, 2000
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4. Transaction Code (Instr. 8)
Code V
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J
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5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.3,
4 and 5)
(A) (D)
88,000
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6. Date Exercisable and Expiration Date: (Month/Day/Year)
Date Exercisable Expiration Date
See "A" Below in 01-05-10
Explanation of Responses
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7. Title and Amount of Underlying Securities - (Instr. 3 and 4)
Title Amount or Number of Shares
Common Stock 88,000
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8. Price of Derivative Security (Instr. 5)
3.00
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9. Number of Derivative Securities Beneficially Owned at End of Month
(Instr. 4)
216,250
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10. Ownership Form of Derivative Security; Direct (D) or Indirect (I) -
(Instr. 4)
D
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11. Nature of Indirect Beneficial Onwerhsip (Instr. 4)
N/A
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Explanation of Responses:
A. Options exercisable as follows:
29,334 on March 31, 2001
29,333 on March 31, 2002
29,333 on March 31, 2003
** Intentional misstatements or omissions of facts constitute Federal
Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed.
If space is insufficient, See Instruction 6 for procedure.
Date: February 7, 2000 /s/ Que H. Christensen
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**Signature of Reporting Person
