Site under routine maintenance. Please see below to access our forms and view our contact information.
CLICK HERE to access the patient portal.
Forms
If you wish to download and complete the forms electronically, you will need Adobe Reader. You can click here to download it for free.
If you do not wish to fill out the forms electronically, you may print a copy, fill it out, and return it to our office.
Click on the desired paperwork at the bottom of this page that you wish to complete. You will automatically be taken to DocHub to electronically complete the form. You will need to create a DocHub account in order to electronically complete the forms. These accounts are entirely free. Once you are redirected to DocHub to fill out the form, click FILL A COPY. Once you have completed and electronically signed your document, simply click FINALIZE. The forms are automatically sent directly back to our office. No additional steps are required.
If you have any questions, please do not hesitate to contact us.
Thank you,
Pulmonary Sleep & Critical Care Specialists
Click the appropriate form(s) below:
New Patient Forms:
New Patient Paperwork
Misc. Forms:
Alternate Provider Disclosure
Records Release
Records Release – Sleep Records
HIPAA
Annual Paperwork
Sleep Forms:
Sleep Forms
Sleep Forms – Spanish
HST Forms
HST Forms – Spanish
Contact Us
Hours of Operation:
Monday thru Friday, 9:00am-5:00pm
Port Charlotte Office
4235 Kings Highway, Suite 103
Port Charlotte, FL 33980
(941) 613-1777
Punta Gorda Office
25086 Olympia Avenue, Suite 300
Punta Gorda, FL 33950
(941) 205-5300
North Port Office
14942 Tamiami Trail, Unit B
North Port, FL 34287
(941) 876-4415
Office Directory
Administration:
(941) 613-1777
Authorization/Referral Department:
(941) 876-4415, ext 103
Billing Department:
(941) 876-4415, ext 115
Facility Manager:
(941) 613-1777
Medical Records:
(941) 613-1777, ext 419
Medication Refill Requests:
(941) 613-1777, ext 408
New Patient Scheduling Department:
(941) 205-5300, ext 404
Radiology Scheduling Department:
(941) 876-4415, ext 108
Sleep Center:
(941) 625-1013, Fax (941) 613-1779
Surgery Scheduling Department:
(941) 876-4415, ext 108
Triage Nurse Line
(941) 613-1777, ext 408
Already established patients needing to schedule or reschedule their appointment should call the office where the appointment is scheduled. New patients needing to reschedule must call the New Patient Scheduling Department.
All medication refill requests need to call into the dedicated Refill Request line.
Thank you for trusting us with your care. We look forward to helping you!