Patient Registration Forms
Welcome to Pulmonary & Sleep Center of Oklahoma serving Tulsa and Northeastern Oklahoma.
Once you have your appointment scheduled you may download, print, and complete the forms below. Please ensure that you bring all the necessary forms with you on your first visit, along with any test results, or film that may have been ordered by another provider.
Click to download:
How can I pay a bill?
To pay a statement received in the mail. You can do one of the following:
- Mail the amount due to the address listed on your statement
- Pay by phone by calling the office
- Pay in person in office
Please call our office with any questions related to billing.
How do I clean my CPAP machine?
Please watch this video on the process to clean and care for your CPAP machine and mask. This will ensure your treatment is more comfortable and effective.
Can my oxygen tank be around anything flammable?
No! You should never have your oxygen tank around anything flammable. This includes, but not limited to, anything with an open flame from cigarettes to a fireplace.
- Phones. Telephones are answered Monday through Friday from 8:00 A.M. to 4:30 P.M.
- Office: 918-307-5490 Fax: 918-779-3247
- Test Results. Should you have any laboratory or other diagnostic testing through our practice, you will receive the results from the physician at your follow up appointment.
- Record Release. Personal record requests and/or record requests to any physician will be available upon written request and authorization. Please allow our office up to 3 business days to process your record request.
- Forms Completion. Our office charges $25 for the completion of forms. These charges will be your responsibility and will be due at the time of the request. Examples: FMLA Paperwork, Disability forms, etc.
- Pets Policy. No pets allowed. Service animals are allowed but are expected to be well behaved.
- Perfumes/Colognes. Please refrain from using heavy perfumes/colognes due to our sensitive respiratory population.
- Insurance and Payment Policy.
- Proof of Insurance. If you fail to provide us with the correct insurance information at each visit, you may be responsible for payment for services charged.
- We are contracted with most insurance plans. If you are insured by a plan we are contracted with, payment is due at the time of service. If you are insured by a plan we are contracted with but don’t have an up-to-date insurance card, payment in full for each visit is required until we can verify your coverage.
- Your health insurance contract is between you and your insurance company. Knowing your insurance benefits is the patient’s responsibility. Any questions or complaints regarding your coverage should be directed to your insurance carrier.
- Co-Payments/Estimates. Your insurance company requires us to collect co-payments, deductibles, and co-insurance at the time of service. Waiver of payments may constitute fraud under federal and state law. If you are unable to pay your copay and/or balances, your appointments may need to be rescheduled. Payments can be made by cash, check, Visa, MasterCard, American Express, or Discover. A $50.00 service fee will be charged for all returned checks.
- Non-covered Services. Please be aware that some or all of the services you receive may not be covered by your insurer. You must pay for these services in full.
- Claims Submission. We will submit your claims and reasonably assist you to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request.
- Partial payments will not be accepted unless otherwise coordinated with our billing office. Unpaid balances over 60 days will be referred to a collection agency and you may be discharged from this practice.
- Appointment- Late Arrival. If you arrive more than 15 minutes late for your appointment, you may be asked to reschedule for another day.
- Missed, Cancelled, and Rescheduled Appointments. Pulmonary and Sleep Center of Oklahoma reserves the right to charge a fee for missed, canceled, and rescheduled appointments with less than sufficient notice. Charges for missed, canceled, and rescheduled appointments will be billed directly to the patient and will not be filed through insurance. Payments for fees must be paid prior to rescheduling the missed, canceled, or rescheduled appointment.
- Canceled or rescheduled office appointments less than 1 business days prior to appointment time will be charged a $20.00 Fee
- Missed appointments without notification (no show) will be charged a $40.00 fee and potential discharge from clinic may occur if deemed excessive.
- Canceled or rescheduled procedures less than 1 business days prior to appointment will be charged with a $100.00 Fee. This includes in-office testing and hospital procedures.
- Missed procedures without notification (no show) will be charged a $200.00 fee and potential discharge from clinic may occur if deemed excessive. This includes in-office tests and hospital procedures.
Calls & Messages
Urgent Calls (acute symptoms and time-sensitive requests) are going to be addressed by the end of the business day.
Non-urgent messages are addressed within 3-5 business days. This includes, but is not limited to, any test or lab results, refills, billing questions, equipment requests, or routine questions.
Please contact your pharmacy for all refill requests.
Learn about CPAP:
Learn more about Sleep:
Learn more about Lung conditions: