Refer a Patient—For physicians
What is required for a complete referral to CMC’s pulmonary rehabilitation program?
- Physician referral / Physician clearance form
- Pulmonary Diagnosis
- Most recent H&P and other pertinent medical information
- Recent EKG within 6 months
- Recent PFT within 2 years
Where can I find the physician clearance form to sign?
Click here to download a referral form, please sign and fax to: 603.665.2449.
You can call also call:
603.665.2545 and the Pulmonary Fitness team will facilitate.