PATIENT FORMS
New Patient Registration
Insurance Information
Insurance Card Verification
Patient Information Release
Financial Policy
Sleep Clinic New Patient
Sleep Clinic Follow-up Form (Dr. Tyson)
Authorization to Release Medical Info | Media Release
Medical Records Release
Non-Discrimination Notice
SPANISH FORMS
At MidState Pulmonary, our patients are our priority. First and foremost, our focus is you–to get to know you–your history, your condition, your questions and your concerns. Learning as much as we can, about you, helps us to provide, you, a more personalized diagnosis and treatment plan.
To better assist you with your first appointment, we are pleased to provide our new patient paperwork online for easy download. We encourage our patients to take the time to complete these forms prior to their appointment.
To access our forms, please scroll over the name of the form (on the left side of the screen) and, when highlighted, the form will appear–simply print, fill-out and bring with you to your appointment. Our patients often comment on how much they appreciate having the opportunity to complete the forms, at home, at their leisure, rather than rushing the day of the appointment. The choice is yours. We are glad to provide these to you the day of your appointment; however, we ask that you arrive 30 minutes prior to your appointment to ensure you have enough time for completion.
Also, please plan to bring any and all medications and supplements you are currently taking; as well as, any paperwork from your primary care physician, the day of your appointment.