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Referring to our Pulmonary Rehab Program

March 10, 2016

Click here for the: Pulmonary Referral Form

When to Refer to Pulmonary Rehab:

Outpatient Qualifying Symptoms:

  • COPD
  • Asthma
  • Emphysema
  • Interstitial Lung Disease
  • Pulmonary Fibrosis
  • COVID-19
  • Other lung diseases & breathing challenges

What we need:

  • Referral Form signed by a Physician (found above)
    • Patient Demographics/Face sheet
    • Qualifying Diagnosis
  • A copy of PFT Results, Labs, medical history, latest progress notes, and medical list.
  • Patient Insurance Information

 

Please fax the above information when making a referral to our Outpatient Cardiac & Pulmonary Rehabilitation Programs to:

Cardiopulmonary Rehab
Referral: (620) 724.5126
Fax: (620) 724.5127
www.GirardMedicalCenter.com

Questions:
Call Monday - Friday 8am - 4pm
(620) 724.5126

 

 

 

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Pulmonary Rehab
Girard Medical Center302 North Hospital DriveGirard, KS  66743PH: 620-724-8291FX: 620-724-6332
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