Patient Forms, Map and Directions to Mansfield Office
Your first visit to Pulmonary Critical Care Professionals, PLLC establishes a vital foundation for our relationship with you. During your first visit, we make sure to obtain important background information about your medical history and give you time to get to know your doctor.
To understand what to expect for your first visit to our practice, please read through this page. You'll find all the practical information you need, such as a map and directions to our office, practice hours, payment policies and more.
Mission Statement
Providing world-class, evidence based lung care with a compassionate patient centric approach.
To fulfill this mission, we are committed to:
- Listening to those we are privileged to serve.
- Earn the trust and respect of patients, profession and community.
- Exceed your expectations.
- Ensure a creative, challenging and compassionate professional environment.
- Strive for continuous improvement at all levels.
Privacy Policy
At our outpatient office, we are committed to maintaining the privacy and confidentiality of your personal information. This Privacy Policy outlines our practices concerning the collection, use, and disclosure of your information when you visit our outpatient office.
1. Information We Collect:
We collect and maintain personal information to provide you with high-quality healthcare services. The information we collect may include, but is not limited to:
· Personal details (name, address, contact information)
· Health information (medical history, current health conditions, medications)
· Insurance information
· Financial information for billing purposes
2. How We Use Your Information:
We use your personal information for the following purposes:
· Providing medical care and treatment
· Scheduling appointments
· Billing and insurance purposes
· Conducting quality assurance and improvement activities
· Complying with legal and regulatory requirements
3. Information Sharing:
We do not disclose your personal information to third parties without your explicit consent, except as required by law or in emergencies. Your information may be shared with healthcare professionals involved in your care and, when necessary, with business associates who assist us in providing services (e.g., billing companies).
4. Security Measures:
We take reasonable steps to safeguard your personal information from unauthorized access, disclosure, alteration, and destruction. We employ physical, electronic, and procedural safeguards to protect your information.
5. Your Rights:
You have the right to:
· Access and obtain a copy of your health records
· Request corrections to your health information
· Request restrictions on certain uses and disclosures
· Revoke consent for the use or disclosure of your information
6. Updates to Privacy Policy:
We may update this Privacy Policy from time to time to reflect changes in our practices. A revised version will be effective upon posting, and we encourage you to review our Privacy Policy periodically.
7. Contact Information:
If you have any questions or concerns regarding this Privacy Policy or the use of your information, please contact our office.
By choosing Pulmonary Critical Care Professionals for your healthcare needs, you acknowledge that you have read and understood this Privacy Policy and agree to its terms.
Patient Forms
Please print and fill out these forms so we can expedite your first visit:
- Forms Coming Soon
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it: 
What To Expect
Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It also will help relieve any unnecessary anxiety you may be feeling. Educate yourself on your symptoms by reviewing the content on this website. Also, take some time to review our staff page and familiarize yourself with the doctors. We look forward to your first visit.