Pima Lung & Sleep, PC - PFT 1

DOS:

PATIENT 1:

Patient: DOB: Age: Greenway ID#:

FEV 1 = FEV 1/FVC = Diffusion =

Comments:

Follow Up Clinic Appointment Date:

Next annual PFT Date:

Upload PFT Cover Sheet + PFT Report:

PATIENT 2:

Patient: DOB: Age: Greenway ID#:

FEV 1 = FEV 1/FVC = Diffusion =

Comments:

Follow Up Clinic Appointment Date:

Next annual PFT Date:

Upload PFT Cover Sheet + PFT Report:

PATIENT 3:

Patient: DOB: Age: Greenway ID#:

FEV 1 = FEV 1/FVC = Diffusion =

Comments:

Follow Up Clinic Appointment Date:

Next annual PFT Date:

Upload PFT Cover Sheet + PFT Report:

PATIENT 4:

Patient: DOB: Age: Greenway ID#:

FEV 1 = FEV 1/FVC = Diffusion =

Comments:

Follow Up Clinic Appointment Date:

Next annual PFT Date:

Upload PFT Cover Sheet + PFT Report:

PATIENT 5:

Patient: DOB: Age: Greenway ID#:

FEV 1 = FEV 1/FVC = Diffusion =

Comments:

Follow Up Clinic Appointment Date:

Next annual PFT Date:

Upload PFT Cover Sheet + PFT Report:

PATIENT 6:

Patient: DOB: Age: Greenway ID#:

FEV 1 = FEV 1/FVC = Diffusion =

Comments:

Follow Up Clinic Appointment Date:

Next annual PFT Date:

Upload PFT Cover Sheet + PFT Report:

PATIENT 7:

Patient: DOB: Age: Greenway ID#:

FEV 1 = FEV 1/FVC = Diffusion =

Comments:

Follow Up Clinic Appointment Date:

Next annual PFT Date:

Upload PFT Cover Sheet + PFT Report:

PATIENT 8:

Patient: DOB: Age: Greenway ID#:

FEV 1 = FEV 1/FVC = Diffusion =

Comments:

Follow Up Clinic Appointment Date:

Next annual PFT Date:

Upload PFT Cover Sheet + PFT Report:

PATIENT 9:

Patient: DOB: Age: Greenway ID#:

FEV 1 = FEV 1/FVC = Diffusion =

Comments:

Follow Up Clinic Appointment Date:

Next annual PFT Date:

Upload PFT Cover Sheet + PFT Report:

PATIENT 10:

Patient: DOB: Age: Greenway ID#:

FEV 1 = FEV 1/FVC = Diffusion =

Comments:

Follow Up Clinic Appointment Date:

Next annual PFT Date:

Upload PFT Cover Sheet + PFT Report:

PATIENT 11:

Patient: DOB: Age: Greenway ID#:

FEV 1 = FEV 1/FVC = Diffusion =

Comments:

Follow Up Clinic Appointment Date:

Next annual PFT Date:

Upload PFT Cover Sheet + PFT Report:

PATIENT 12:

Patient: DOB: Age: Greenway ID#:

FEV 1 = FEV 1/FVC = Diffusion =

Comments:

Follow Up Clinic Appointment Date:

Next annual PFT Date:

Upload PFT Cover Sheet + PFT Report:

PATIENT 13:

Patient: DOB: Age: Greenway ID#:

FEV 1 = FEV 1/FVC = Diffusion =

Comments:

Follow Up Clinic Appointment Date:

Next annual PFT Date:

Upload PFT Cover Sheet + PFT Report:

PATIENT 14:

Patient: DOB: Age: Greenway ID#:

FEV 1 = FEV 1/FVC = Diffusion =

Comments:

Follow Up Clinic Appointment Date:

Next annual PFT Date:

Upload PFT Cover Sheet + PFT Report:

PATIENT 15:

Patient: DOB: Age: Greenway ID#:

FEV 1 = FEV 1/FVC = Diffusion =

Comments:

Follow Up Clinic Appointment Date:

Next annual PFT Date:

Upload PFT Cover Sheet + PFT Report:

PATIENT 16:

Patient: DOB: Age: Greenway ID#:

FEV 1 = FEV 1/FVC = Diffusion =

Comments:

Follow Up Clinic Appointment Date:

Next annual PFT Date:

Upload PFT Cover Sheet + PFT Report:

PATIENT 17:

Patient: DOB: Age: Greenway ID#:

FEV 1 = FEV 1/FVC = Diffusion =

Comments:

Follow Up Clinic Appointment Date:

Next annual PFT Date:

Upload PFT Cover Sheet + PFT Report:

PATIENT 18:

Patient: DOB: Age: Greenway ID#:

FEV 1 = FEV 1/FVC = Diffusion =

Comments:

Follow Up Clinic Appointment Date:

Next annual PFT Date:

Upload PFT Cover Sheet + PFT Report:

PATIENT 19:

Patient: DOB: Age: Greenway ID#:

FEV 1 = FEV 1/FVC = Diffusion =

Comments:

Follow Up Clinic Appointment Date:

Next annual PFT Date:

Upload PFT Cover Sheet + PFT Report:

PATIENT 20:

Patient: DOB: Age: Greenway ID#:

FEV 1 = FEV 1/FVC = Diffusion =

Comments:

Follow Up Clinic Appointment Date:

Next annual PFT Date:

Upload PFT Cover Sheet + PFT Report: