Pulmonary and Critical Care Forms

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Medical Record Update Electronic Link

Please use the link below to update your medical record anytime prior to coming to our office. When you check-in, the information will download into your chart for your care team to review.

Forms

New Patient Welcome Letter

Welcome Letter

History and Physical

History and Physical Form

No Show Policy

“No Show” Policy

Authorization to Release Medical Information

Authorization to Release Medical Information

Authorization Disclosure of Protected Health Information

Pulmonary and Critical Care Authorization for Disclosure of Protected Health Information Form

Our Physicians

Hemal H. Mehta, MD

Hemal H. Mehta, MD

Pulmonary/Critical Care
Justin Pi, MD

Justin Pi, MD

Pulmonary/Critical Care
Oleksandr Pistun, MD

Oleksandr Pistun, MD

Pulmonary/Critical Care
Bruno L. Schremmer, MD

Bruno L. Schremmer, MD

Pulmonary/Critical Care
Marylou Nace, NP-C

Marylou Nace, NP-C

Pulmonary/Critical Care
Theresa Tomy, NP-C

Theresa Tomy, NP-C

Pulmonary/Critical Care
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