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PatientInfo

The Doctors of Dallaspulmonary.com

What to Bring to Your Appointment
Patient Forms
Payment and Insurance Information
Notice of Privacy Practices

What to Bring to Your Appointment

  • Your insurance card
  • Physician referral forms if required by insurance
  • A list of current prescriptions and/or over-the-counter medications you are taking, including dose and frequency
  • Pertinent information about your medical and surgical history
  • Any recent x-rays or appropriate records you may have

Patient Forms

For your convenience, you can download our patient forms using the links below. Please print the form and complete it before your appointment.

For patients of Dr. Loftin:

For patients of Dr. Tompkins:

[Need help downloading the form?]

Payment and Insurance Information

Dallas Pulmonary Associates is a provider for Medicare and most major insurance plans. We provide insurance billing. Please be aware that any costs not covered by insurance are your responsibility.

For services that are not covered by insurance, we request payment at the time of your appointment. Your insurance company may also require you to pay a co-payment at the time of your appointment. When necessary, our staff will work closely with patients who require a payment plan.

If you have any questions regarding which insurance plans we accept or any billing concerns, please call us at the phone number below. Questions regarding your coverage and benefits should be directed to your employer or insurance company.



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The Doctors of Dallaspulmonary.com

4333 N. Josey Lane
Plaza 2, Suite 207
Carrollton, Texas 75010
Tel: 972.394.2971
Fax: 972.492.1261

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