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Holy Redeemer
Medical Office Building
1650 Huntingdon Pike, Suite 305
Meadowbrook, PA 19046

Hours
Mon - Fri 9:00am – 5:00pm

PATIENT FORMS


Welcome to Redeemer Pulmonary Associates. As a new patient, you will be required to complete some forms before your appointment. These forms will be mailed to you. In order to make your first appointment go as quickly and smoothly as possible, please complete all forms and bring them with you to your first appointment along with your most recent insurance card, driver’s license or other photo ID and your co-payment. If you have copies of recent test results or a disc of any radiology studies that were NOT performed at Holy Redeemer, please bring them as well. If you’re a new patient, please arrive 15 minutes before your scheduled appointment.

If your insurance requires you to get a referral from your PCP, our NPI number is 1992707962.

Co-pay is expected at the time of your appointment. We accept cash, check, VISA, MasterCard and Discover.

Please note: We need the actual insurance card in order to scan it into the system.  We cannot scan a paper from the insurance company stating coverage or a picture of an insurance card from a cell phone.

 

PDF TX-65Patient Information

 

PDF TX-65Authorization to Speak to Another Regarding Medical Care

 

PDF TX-65Consent for Financial Responsibility

 

PDF TX-65General Consent to Treatment

 

PDF TX-65Authorization for Access or Release of Protected Health Information

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icon-online

eCare Patient Portal

Get Directions


Holy Redeemer
Medical Office Building
1650 Huntingdon Pike, Suite 305
Meadowbrook, PA 19046

Hours
Mon - Fri 9:00am – 5:00pm