Refer a Patient—For physicians
What is required for a complete referral to 梦三国2 ’s pulmonary rehabilitation program?
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Physician referral / Physician clearance form
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Pulmonary Diagnosis
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Most recent H&P and other pertinent medical information
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Recent EKG within 6 months
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Recent PFT within 2 years
Where can I find the physician clearance form to sign?
Click here to download a referral form
, please sign and fax to: 603.665.2449.
You can call also call:
603.665.2545
and the Pulmonary Fitness team will facilitate.