Salem Pulmonary Associates, PC

Your Local Specialists for Pulmonary Disease

Serving Salem, Oregon and the Willamette Valley

Forms For Providers

For Referring Physician Offices only:

Please fill out the form indicating what you are referring your patient for. Please be sure to indicate if it is a TEST ONLY. Please fax this form to our office along with patient demographic information and recent chart notes, diagnosis, and appropriate test results.

PFT Referral

Sleep Referral Form-  Please click the link below to print out our Sleep Referral Form.

Sleep Referral Form