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Patient Forms

New Patient Packet / Questionnaire:

To assist a Chest Medicine Associates physician in providing a comprehensive evaluation, at the direction of your health care provider, please complete the New Patient Packet and return to Chest Medicine Associates. Upon receipt of all documentation from your health care provider and your Patient Questionnaire, our consultation coordinator will call you to schedule an appointment. Completed documents can be mailed to Chest Medicine Associates, 100 Foden Road, Suite 103, South Portland, ME 04106 or fax to 207-828-0188.

Release of Information Form:

If you would like to have your medical records at Chest Medicine Associates released to another provider, please complete this form and either fax to 207-772-1474 or mail to our office.

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