SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Cambre Jerome

(Last) (First) (Middle)
625 E. KALISTE SALOOM RD.

(Street)
LAFAYETTE LA 70508

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
12/31/2020
3. Issuer Name and Ticker or Trading Symbol
VIEMED HEALTHCARE, INC. [ VMD ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Vice President of Sales
5. If Amendment, Date of Original Filed (Month/Day/Year)
12/31/2020
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Phantom Share Units(1) (2) 05/09/2021 Common Shares 14,621 0.0(3) D
Phantom Share Units(1) (4) 05/09/2022 Common Shares 2,274 0.0(3) D
Phantom Share Units(1) (5) 05/09/2023 Common Shares 2,772 0.0(3) D
Explanation of Responses:
1. The original Form 3 filed on December 31, 2020 is being amended by this Form 3/A solely to include Phantom Share Units held by the reporting person that were unintentionally omitted.
2. Represents an award granted in 2018 under the Issuer's Phantom Share Unit Plan which vests on May 9, 2021, subject to the Reporting Person's continued employment with the Issuer on such vesting date.
3. Each share of phantom stock represents a right to receive the cash value of one share of the Issuer's common stock which will be determined based on the Issuer's share price on the vesting date.
4. Represents an award granted in 2019 under the Issuer's Phantom Share Unit Plan which vests in equal installments on May 9, 2021 and May 9, 2022, subject to the Reporting Person's continued employment with the Issuer on such vesting date.
5. Represents an award granted in 2020 under the Issuer's Phantom Share Unit Plan which vests in equal installments on May 9, 2021, May 9, 2022, and May 9, 2023, subject to the Reporting Person's continued employment with the Issuer on such vesting date.
Remarks:
/s/ Jerome Cambre 01/06/2021
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** 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.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.