Pulmonary and Critical Care of Austin
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Patient Forms

For your convenience, we have listed all of the forms that you will be asked to fill out when you visit our office. Filling out these forms prior to your visit can save significant time during the check-in process.

Clicking on the links below will open, or otherwise download, the associated form.

Please call our office at 512.459.6599 if you have any difficulities with, or questions about, these forms.

New Patient Forms:

If you are a new patient, please fill out the five following forms prior to your visit and bring them with you. The sixth form only needs to be filled out if you are a new patient being referred for obstructive sleep apnea. If you are not sure whether your are being referred for obstructive sleep apnea please call us at 512.459.6599.

  1. Notice of Privacy Practices
  2. New Patient Questionnaire
  3. Patient Data Form
  4. Nurse Practitioner Consent
  5. Office Policy on Standard Insurance and Managed Care Insurers
  6. Sleep Questionnaire - only fill this form out if you are being referred for obstructive sleep apnea

Established Patient Forms:

If you are an established patient in our office, please fill out the two following forms prior to your visit and bring them with you.

  1. Established Patient Questionnaire
  2. Patient Data Form

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Pulmonary and Critical Care Consultants of Austin