<html xmlns:v="urn:schemas-microsoft-com:vml"
xmlns:o="urn:schemas-microsoft-com:office:office"
xmlns:w="urn:schemas-microsoft-com:office:word"
xmlns:m="http://schemas.microsoft.com/office/2004/12/omml"
xmlns="http://www.w3.org/TR/REC-html40">

<head>
<meta http-equiv=Content-Type content="text/html; charset=unicode">
<meta name=ProgId content=Word.Document>
<meta name=Generator content="Microsoft Word 14">
<meta name=Originator content="Microsoft Word 14">
<link rel=File-List href="paforms-new_files/filelist.xml">
<link rel=Edit-Time-Data href="paforms-new_files/editdata.mso">
<!--[if !mso]>
<style>
v\:* {behavior:url(#default#VML);}
o\:* {behavior:url(#default#VML);}
w\:* {behavior:url(#default#VML);}
.shape {behavior:url(#default#VML);}
</style>
<![endif]-->
<title>: Critical Care, Pulmonary &amp; Sleep Associates Patient Forms</title>
<!--[if gte mso 9]><xml>
 <o:DocumentProperties>
  <o:Author>Gary Pearson</o:Author>
  <o:LastAuthor>Gary Pearson</o:LastAuthor>
  <o:Revision>2</o:Revision>
  <o:TotalTime>3</o:TotalTime>
  <o:Created>2013-02-28T21:39:00Z</o:Created>
  <o:LastSaved>2013-02-28T21:39:00Z</o:LastSaved>
  <o:Pages>1</o:Pages>
  <o:Words>487</o:Words>
  <o:Characters>2779</o:Characters>
  <o:Lines>23</o:Lines>
  <o:Paragraphs>6</o:Paragraphs>
  <o:CharactersWithSpaces>3260</o:CharactersWithSpaces>
  <o:Version>14.00</o:Version>
 </o:DocumentProperties>
 <o:OfficeDocumentSettings>
  <o:AllowPNG/>
 </o:OfficeDocumentSettings>
</xml><![endif]-->
<link rel=themeData href="paforms-new_files/themedata.thmx">
<link rel=colorSchemeMapping href="paforms-new_files/colorschememapping.xml">
<!--[if gte mso 9]><xml>
 <w:WordDocument>
  <w:View>Outline</w:View>
  <w:TrackMoves>false</w:TrackMoves>
  <w:TrackFormatting/>
  <w:ValidateAgainstSchemas/>
  <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid>
  <w:IgnoreMixedContent>false</w:IgnoreMixedContent>
  <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText>
  <w:DoNotPromoteQF/>
  <w:LidThemeOther>EN-US</w:LidThemeOther>
  <w:LidThemeAsian>X-NONE</w:LidThemeAsian>
  <w:LidThemeComplexScript>X-NONE</w:LidThemeComplexScript>
  <w:Compatibility>
   <w:BreakWrappedTables/>
   <w:SplitPgBreakAndParaMark/>
  </w:Compatibility>
  <m:mathPr>
   <m:mathFont m:val="Cambria Math"/>
   <m:brkBin m:val="before"/>
   <m:brkBinSub m:val="&#45;-"/>
   <m:smallFrac m:val="off"/>
   <m:dispDef/>
   <m:lMargin m:val="0"/>
   <m:rMargin m:val="0"/>
   <m:defJc m:val="centerGroup"/>
   <m:wrapIndent m:val="1440"/>
   <m:intLim m:val="subSup"/>
   <m:naryLim m:val="undOvr"/>
  </m:mathPr></w:WordDocument>
</xml><![endif]--><!--[if gte mso 9]><xml>
 <w:LatentStyles DefLockedState="false" DefUnhideWhenUsed="true"
  DefSemiHidden="true" DefQFormat="false" DefPriority="99"
  LatentStyleCount="267">
  <w:LsdException Locked="false" Priority="0" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Normal"/>
  <w:LsdException Locked="false" Priority="9" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="heading 1"/>
  <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 2"/>
  <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 3"/>
  <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 4"/>
  <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 5"/>
  <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 6"/>
  <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 7"/>
  <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 8"/>
  <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 9"/>
  <w:LsdException Locked="false" Priority="39" Name="toc 1"/>
  <w:LsdException Locked="false" Priority="39" Name="toc 2"/>
  <w:LsdException Locked="false" Priority="39" Name="toc 3"/>
  <w:LsdException Locked="false" Priority="39" Name="toc 4"/>
  <w:LsdException Locked="false" Priority="39" Name="toc 5"/>
  <w:LsdException Locked="false" Priority="39" Name="toc 6"/>
  <w:LsdException Locked="false" Priority="39" Name="toc 7"/>
  <w:LsdException Locked="false" Priority="39" Name="toc 8"/>
  <w:LsdException Locked="false" Priority="39" Name="toc 9"/>
  <w:LsdException Locked="false" Priority="35" QFormat="true" Name="caption"/>
  <w:LsdException Locked="false" Priority="10" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Title"/>
  <w:LsdException Locked="false" Priority="1" Name="Default Paragraph Font"/>
  <w:LsdException Locked="false" Priority="11" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Subtitle"/>
  <w:LsdException Locked="false" Priority="22" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Strong"/>
  <w:LsdException Locked="false" Priority="20" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Emphasis"/>
  <w:LsdException Locked="false" Priority="59" SemiHidden="false"
   UnhideWhenUsed="false" Name="Table Grid"/>
  <w:LsdException Locked="false" UnhideWhenUsed="false" Name="Placeholder Text"/>
  <w:LsdException Locked="false" Priority="1" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="No Spacing"/>
  <w:LsdException Locked="false" Priority="60" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Shading"/>
  <w:LsdException Locked="false" Priority="61" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light List"/>
  <w:LsdException Locked="false" Priority="62" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Grid"/>
  <w:LsdException Locked="false" Priority="63" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 1"/>
  <w:LsdException Locked="false" Priority="64" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 2"/>
  <w:LsdException Locked="false" Priority="65" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 1"/>
  <w:LsdException Locked="false" Priority="66" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 2"/>
  <w:LsdException Locked="false" Priority="67" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 1"/>
  <w:LsdException Locked="false" Priority="68" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 2"/>
  <w:LsdException Locked="false" Priority="69" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 3"/>
  <w:LsdException Locked="false" Priority="70" SemiHidden="false"
   UnhideWhenUsed="false" Name="Dark List"/>
  <w:LsdException Locked="false" Priority="71" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Shading"/>
  <w:LsdException Locked="false" Priority="72" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful List"/>
  <w:LsdException Locked="false" Priority="73" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Grid"/>
  <w:LsdException Locked="false" Priority="60" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Shading Accent 1"/>
  <w:LsdException Locked="false" Priority="61" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light List Accent 1"/>
  <w:LsdException Locked="false" Priority="62" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Grid Accent 1"/>
  <w:LsdException Locked="false" Priority="63" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 1 Accent 1"/>
  <w:LsdException Locked="false" Priority="64" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 2 Accent 1"/>
  <w:LsdException Locked="false" Priority="65" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 1 Accent 1"/>
  <w:LsdException Locked="false" UnhideWhenUsed="false" Name="Revision"/>
  <w:LsdException Locked="false" Priority="34" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="List Paragraph"/>
  <w:LsdException Locked="false" Priority="29" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Quote"/>
  <w:LsdException Locked="false" Priority="30" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Intense Quote"/>
  <w:LsdException Locked="false" Priority="66" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 2 Accent 1"/>
  <w:LsdException Locked="false" Priority="67" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 1 Accent 1"/>
  <w:LsdException Locked="false" Priority="68" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 2 Accent 1"/>
  <w:LsdException Locked="false" Priority="69" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 3 Accent 1"/>
  <w:LsdException Locked="false" Priority="70" SemiHidden="false"
   UnhideWhenUsed="false" Name="Dark List Accent 1"/>
  <w:LsdException Locked="false" Priority="71" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Shading Accent 1"/>
  <w:LsdException Locked="false" Priority="72" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful List Accent 1"/>
  <w:LsdException Locked="false" Priority="73" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Grid Accent 1"/>
  <w:LsdException Locked="false" Priority="60" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Shading Accent 2"/>
  <w:LsdException Locked="false" Priority="61" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light List Accent 2"/>
  <w:LsdException Locked="false" Priority="62" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Grid Accent 2"/>
  <w:LsdException Locked="false" Priority="63" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 1 Accent 2"/>
  <w:LsdException Locked="false" Priority="64" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 2 Accent 2"/>
  <w:LsdException Locked="false" Priority="65" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 1 Accent 2"/>
  <w:LsdException Locked="false" Priority="66" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 2 Accent 2"/>
  <w:LsdException Locked="false" Priority="67" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 1 Accent 2"/>
  <w:LsdException Locked="false" Priority="68" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 2 Accent 2"/>
  <w:LsdException Locked="false" Priority="69" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 3 Accent 2"/>
  <w:LsdException Locked="false" Priority="70" SemiHidden="false"
   UnhideWhenUsed="false" Name="Dark List Accent 2"/>
  <w:LsdException Locked="false" Priority="71" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Shading Accent 2"/>
  <w:LsdException Locked="false" Priority="72" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful List Accent 2"/>
  <w:LsdException Locked="false" Priority="73" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Grid Accent 2"/>
  <w:LsdException Locked="false" Priority="60" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Shading Accent 3"/>
  <w:LsdException Locked="false" Priority="61" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light List Accent 3"/>
  <w:LsdException Locked="false" Priority="62" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Grid Accent 3"/>
  <w:LsdException Locked="false" Priority="63" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 1 Accent 3"/>
  <w:LsdException Locked="false" Priority="64" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 2 Accent 3"/>
  <w:LsdException Locked="false" Priority="65" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 1 Accent 3"/>
  <w:LsdException Locked="false" Priority="66" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 2 Accent 3"/>
  <w:LsdException Locked="false" Priority="67" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 1 Accent 3"/>
  <w:LsdException Locked="false" Priority="68" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 2 Accent 3"/>
  <w:LsdException Locked="false" Priority="69" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 3 Accent 3"/>
  <w:LsdException Locked="false" Priority="70" SemiHidden="false"
   UnhideWhenUsed="false" Name="Dark List Accent 3"/>
  <w:LsdException Locked="false" Priority="71" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Shading Accent 3"/>
  <w:LsdException Locked="false" Priority="72" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful List Accent 3"/>
  <w:LsdException Locked="false" Priority="73" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Grid Accent 3"/>
  <w:LsdException Locked="false" Priority="60" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Shading Accent 4"/>
  <w:LsdException Locked="false" Priority="61" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light List Accent 4"/>
  <w:LsdException Locked="false" Priority="62" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Grid Accent 4"/>
  <w:LsdException Locked="false" Priority="63" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 1 Accent 4"/>
  <w:LsdException Locked="false" Priority="64" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 2 Accent 4"/>
  <w:LsdException Locked="false" Priority="65" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 1 Accent 4"/>
  <w:LsdException Locked="false" Priority="66" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 2 Accent 4"/>
  <w:LsdException Locked="false" Priority="67" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 1 Accent 4"/>
  <w:LsdException Locked="false" Priority="68" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 2 Accent 4"/>
  <w:LsdException Locked="false" Priority="69" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 3 Accent 4"/>
  <w:LsdException Locked="false" Priority="70" SemiHidden="false"
   UnhideWhenUsed="false" Name="Dark List Accent 4"/>
  <w:LsdException Locked="false" Priority="71" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Shading Accent 4"/>
  <w:LsdException Locked="false" Priority="72" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful List Accent 4"/>
  <w:LsdException Locked="false" Priority="73" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Grid Accent 4"/>
  <w:LsdException Locked="false" Priority="60" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Shading Accent 5"/>
  <w:LsdException Locked="false" Priority="61" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light List Accent 5"/>
  <w:LsdException Locked="false" Priority="62" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Grid Accent 5"/>
  <w:LsdException Locked="false" Priority="63" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 1 Accent 5"/>
  <w:LsdException Locked="false" Priority="64" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 2 Accent 5"/>
  <w:LsdException Locked="false" Priority="65" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 1 Accent 5"/>
  <w:LsdException Locked="false" Priority="66" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 2 Accent 5"/>
  <w:LsdException Locked="false" Priority="67" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 1 Accent 5"/>
  <w:LsdException Locked="false" Priority="68" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 2 Accent 5"/>
  <w:LsdException Locked="false" Priority="69" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 3 Accent 5"/>
  <w:LsdException Locked="false" Priority="70" SemiHidden="false"
   UnhideWhenUsed="false" Name="Dark List Accent 5"/>
  <w:LsdException Locked="false" Priority="71" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Shading Accent 5"/>
  <w:LsdException Locked="false" Priority="72" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful List Accent 5"/>
  <w:LsdException Locked="false" Priority="73" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Grid Accent 5"/>
  <w:LsdException Locked="false" Priority="60" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Shading Accent 6"/>
  <w:LsdException Locked="false" Priority="61" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light List Accent 6"/>
  <w:LsdException Locked="false" Priority="62" SemiHidden="false"
   UnhideWhenUsed="false" Name="Light Grid Accent 6"/>
  <w:LsdException Locked="false" Priority="63" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 1 Accent 6"/>
  <w:LsdException Locked="false" Priority="64" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Shading 2 Accent 6"/>
  <w:LsdException Locked="false" Priority="65" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 1 Accent 6"/>
  <w:LsdException Locked="false" Priority="66" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium List 2 Accent 6"/>
  <w:LsdException Locked="false" Priority="67" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 1 Accent 6"/>
  <w:LsdException Locked="false" Priority="68" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 2 Accent 6"/>
  <w:LsdException Locked="false" Priority="69" SemiHidden="false"
   UnhideWhenUsed="false" Name="Medium Grid 3 Accent 6"/>
  <w:LsdException Locked="false" Priority="70" SemiHidden="false"
   UnhideWhenUsed="false" Name="Dark List Accent 6"/>
  <w:LsdException Locked="false" Priority="71" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Shading Accent 6"/>
  <w:LsdException Locked="false" Priority="72" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful List Accent 6"/>
  <w:LsdException Locked="false" Priority="73" SemiHidden="false"
   UnhideWhenUsed="false" Name="Colorful Grid Accent 6"/>
  <w:LsdException Locked="false" Priority="19" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Subtle Emphasis"/>
  <w:LsdException Locked="false" Priority="21" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Intense Emphasis"/>
  <w:LsdException Locked="false" Priority="31" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Subtle Reference"/>
  <w:LsdException Locked="false" Priority="32" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Intense Reference"/>
  <w:LsdException Locked="false" Priority="33" SemiHidden="false"
   UnhideWhenUsed="false" QFormat="true" Name="Book Title"/>
  <w:LsdException Locked="false" Priority="37" Name="Bibliography"/>
  <w:LsdException Locked="false" Priority="39" QFormat="true" Name="TOC Heading"/>
 </w:LatentStyles>
</xml><![endif]-->
<link rel=Stylesheet type="text/css" media=all href=criticalstyle.css>
<style>
<!--
a:active, a:focus {
	outline: 0;
}

 /* Font Definitions */
 @font-face
	{font-family:"Cambria Math";
	panose-1:2 4 5 3 5 4 6 3 2 4;
	mso-font-charset:1;
	mso-generic-font-family:roman;
	mso-font-format:other;
	mso-font-pitch:variable;
	mso-font-signature:0 0 0 0 0 0;}
@font-face
	{font-family:Tahoma;
	panose-1:2 11 6 4 3 5 4 4 2 4;
	mso-font-charset:0;
	mso-generic-font-family:swiss;
	mso-font-pitch:variable;
	mso-font-signature:-520081665 -1073717157 41 0 66047 0;}
 /* Style Definitions */
 p.MsoNormal, li.MsoNormal, div.MsoNormal
	{mso-style-unhide:no;
	mso-style-qformat:yes;
	mso-style-parent:"";
	margin:0in;
	margin-bottom:.0001pt;
	mso-pagination:widow-orphan;
	font-size:12.0pt;
	font-family:"Times New Roman","serif";
	mso-fareast-font-family:"Times New Roman";
	mso-fareast-theme-font:minor-fareast;}
a:link, span.MsoHyperlink
	{mso-style-noshow:yes;
	mso-style-priority:99;
	color:blue;
	mso-text-animation:none;
	text-decoration:none;
	text-underline:none;
	text-decoration:none;
	text-line-through:none;}
a:visited, span.MsoHyperlinkFollowed
	{mso-style-noshow:yes;
	mso-style-priority:99;
	color:purple;
	mso-text-animation:none;
	text-decoration:none;
	text-underline:none;
	text-decoration:none;
	text-line-through:none;}
p.MsoAcetate, li.MsoAcetate, div.MsoAcetate
	{mso-style-noshow:yes;
	mso-style-priority:99;
	mso-style-link:"Balloon Text Char";
	margin:0in;
	margin-bottom:.0001pt;
	mso-pagination:widow-orphan;
	font-size:8.0pt;
	font-family:"Tahoma","sans-serif";
	mso-fareast-font-family:"Times New Roman";
	mso-fareast-theme-font:minor-fareast;}
p.disclaimer, li.disclaimer, div.disclaimer
	{mso-style-name:disclaimer;
	mso-style-unhide:no;
	mso-margin-top-alt:auto;
	margin-right:0in;
	mso-margin-bottom-alt:auto;
	margin-left:0in;
	mso-pagination:widow-orphan;
	font-size:8.0pt;
	mso-fareast-font-family:"Times New Roman";
	mso-fareast-theme-font:minor-fareast;}
p.content, li.content, div.content
	{mso-style-name:content;
	mso-style-unhide:no;
	mso-margin-top-alt:auto;
	margin-right:0in;
	mso-margin-bottom-alt:auto;
	margin-left:0in;
	mso-pagination:widow-orphan;
	font-size:9.0pt;
	mso-fareast-font-family:"Times New Roman";
	mso-fareast-theme-font:minor-fareast;}
p.footer, li.footer, div.footer
	{mso-style-name:footer;
	mso-style-unhide:no;
	mso-margin-top-alt:auto;
	margin-right:0in;
	mso-margin-bottom-alt:auto;
	margin-left:0in;
	mso-pagination:widow-orphan;
	font-size:8.0pt;
	mso-fareast-font-family:"Times New Roman";
	mso-fareast-theme-font:minor-fareast;}
p.blue, li.blue, div.blue
	{mso-style-name:blue;
	mso-style-unhide:no;
	mso-margin-top-alt:auto;
	margin-right:0in;
	mso-margin-bottom-alt:auto;
	margin-left:0in;
	mso-pagination:widow-orphan;
	font-size:9.0pt;
	mso-fareast-font-family:"Times New Roman";
	mso-fareast-theme-font:minor-fareast;}
p.bluesmall, li.bluesmall, div.bluesmall
	{mso-style-name:bluesmall;
	mso-style-unhide:no;
	mso-margin-top-alt:auto;
	margin-right:0in;
	mso-margin-bottom-alt:auto;
	margin-left:0in;
	mso-pagination:widow-orphan;
	font-size:8.0pt;
	mso-fareast-font-family:"Times New Roman";
	mso-fareast-theme-font:minor-fareast;}
p.smalltablecontent, li.smalltablecontent, div.smalltablecontent
	{mso-style-name:smalltablecontent;
	mso-style-unhide:no;
	mso-margin-top-alt:auto;
	margin-right:0in;
	mso-margin-bottom-alt:auto;
	margin-left:0in;
	mso-pagination:widow-orphan;
	font-size:8.5pt;
	mso-fareast-font-family:"Times New Roman";
	mso-fareast-theme-font:minor-fareast;}
p.orange, li.orange, div.orange
	{mso-style-name:orange;
	mso-style-unhide:no;
	mso-margin-top-alt:auto;
	margin-right:0in;
	mso-margin-bottom-alt:auto;
	margin-left:0in;
	mso-pagination:widow-orphan;
	font-size:9.0pt;
	mso-fareast-font-family:"Times New Roman";
	mso-fareast-theme-font:minor-fareast;}
p.orangeast, li.orangeast, div.orangeast
	{mso-style-name:orangeast;
	mso-style-unhide:no;
	mso-margin-top-alt:auto;
	margin-right:0in;
	mso-margin-bottom-alt:auto;
	margin-left:0in;
	mso-pagination:widow-orphan;
	font-size:24.0pt;
	mso-fareast-font-family:"Times New Roman";
	mso-fareast-theme-font:minor-fareast;}
p.bluelinks, li.bluelinks, div.bluelinks
	{mso-style-name:bluelinks;
	mso-style-unhide:no;
	mso-margin-top-alt:auto;
	margin-right:0in;
	mso-margin-bottom-alt:auto;
	margin-left:0in;
	mso-pagination:widow-orphan;
	font-size:12.0pt;
	font-family:"Times New Roman","serif";
	mso-fareast-font-family:"Times New Roman";
	mso-fareast-theme-font:minor-fareast;}
p.white, li.white, div.white
	{mso-style-name:white;
	mso-style-unhide:no;
	mso-margin-top-alt:auto;
	margin-right:0in;
	mso-margin-bottom-alt:auto;
	margin-left:0in;
	mso-pagination:widow-orphan;
	font-size:11.0pt;
	mso-fareast-font-family:"Times New Roman";
	mso-fareast-theme-font:minor-fareast;}
p.bluesmallk, li.bluesmallk, div.bluesmallk
	{mso-style-name:bluesmallk;
	mso-style-unhide:no;
	mso-margin-top-alt:auto;
	margin-right:0in;
	mso-margin-bottom-alt:auto;
	margin-left:0in;
	mso-pagination:widow-orphan;
	font-size:9.0pt;
	mso-fareast-font-family:"Times New Roman";
	mso-fareast-theme-font:minor-fareast;}
span.BalloonTextChar
	{mso-style-name:"Balloon Text Char";
	mso-style-noshow:yes;
	mso-style-priority:99;
	mso-style-unhide:no;
	mso-style-locked:yes;
	mso-style-link:"Balloon Text";
	mso-ansi-font-size:8.0pt;
	mso-bidi-font-size:8.0pt;
	font-family:"Tahoma","sans-serif";
	mso-ascii-font-family:Tahoma;
	mso-fareast-font-family:"Times New Roman";
	mso-fareast-theme-font:minor-fareast;
	mso-hansi-font-family:Tahoma;
	mso-bidi-font-family:Tahoma;}
.MsoChpDefault
	{mso-style-type:export-only;
	mso-default-props:yes;
	font-size:10.0pt;
	mso-ansi-font-size:10.0pt;
	mso-bidi-font-size:10.0pt;}
@page WordSection1
	{size:8.5in 11.0in;
	margin:1.0in 1.0in 1.0in 1.0in;
	mso-header-margin:.5in;
	mso-footer-margin:.5in;
	mso-paper-source:0;}
div.WordSection1
	{page:WordSection1;}
-->
</style>
<!--[if gte mso 10]>
<style>
 /* Style Definitions */
 table.MsoNormalTable
	{mso-style-name:"Table Normal";
	mso-tstyle-rowband-size:0;
	mso-tstyle-colband-size:0;
	mso-style-noshow:yes;
	mso-style-priority:99;
	mso-style-parent:"";
	mso-padding-alt:0in 5.4pt 0in 5.4pt;
	mso-para-margin:0in;
	mso-para-margin-bottom:.0001pt;
	mso-pagination:widow-orphan;
	font-size:10.0pt;
	font-family:"Times New Roman","serif";}
</style>
<![endif]-->
<meta name=description
content="Office forms for our current and potential patient to complete prior to office appointments">
<meta name=keywords
content="New Patient Overview, Patient Information, Privacy Agreement, Policy, Sleep Questionnaire, Pulmonary Heath Questionnaire">

<script  type="text/javascript">
<!--
function MM_preloadImages() { //v3.0
  var d=document; if(d.images){ if(!d.MM_p) d.MM_p=new Array();
    var i,j=d.MM_p.length,a=MM_preloadImages.arguments; for(i=0; i<a.length; i++)
    if (a[i].indexOf("#")!=0){ d.MM_p[j]=new Image; d.MM_p[j++].src=a[i];}}
}
function MM_swapImgRestore() { //v3.0
  var i,x,a=document.MM_sr; for(i=0;a&&i<a.length&&(x=a[i])&&x.oSrc;i++) x.src=x.oSrc;
}
function MM_findObj(n, d) { //v4.01
  var p,i,x;  if(!d) d=document; if((p=n.indexOf("?"))>0&&parent.frames.length) {
    d=parent.frames[n.substring(p+1)].document; n=n.substring(0,p);}
  if(!(x=d[n])&&d.all) x=d.all[n]; for (i=0;!x&&i<d.forms.length;i++) x=d.forms[i][n];
  for(i=0;!x&&d.layers&&i<d.layers.length;i++) x=MM_findObj(n,d.layers[i].document);
  if(!x && d.getElementById) x=d.getElementById(n); return x;
}

function MM_swapImage() { //v3.0
  var i,j=0,x,a=MM_swapImage.arguments; document.MM_sr=new Array; for(i=0;i<(a.length-2);i+=3)
   if ((x=MM_findObj(a[i]))!=null){document.MM_sr[j++]=x; if(!x.oSrc) x.oSrc=x.src; x.src=a[i+2];}
}
//-->
</script>
<!--[if gte mso 9]><xml>
 <o:shapedefaults v:ext="edit" spidmax="1026"/>
</xml><![endif]--><!--[if gte mso 9]><xml>
 <o:shapelayout v:ext="edit">
  <o:idmap v:ext="edit" data="1"/>
 </o:shapelayout></xml><![endif]-->
</head>

<body lang=EN-US link=blue vlink=purple style='tab-interval:.5in'
onload="MM_preloadImages('images/nav/homeon.gif','images/nav/serviceson.gif','images/nav/physicianon.gif','images/nav/patienton.gif','images/nav/educationon.gif','images/nav/policeson.gif','images/nav/contacton.gif')">

<div class=WordSection1>

<table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width="100%"
 style='width:100.0%;mso-cellspacing:0in;mso-yfti-tbllook:1184;mso-padding-alt:
 0in 0in 0in 0in'>
 <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'>
  <td valign=top style='padding:0in 0in 0in 0in'>
  <div align=center>
  <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width=792
   style='width:8.25in;mso-cellspacing:0in;mso-yfti-tbllook:1184;mso-padding-alt:
   0in 0in 0in 0in'>
   <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'>
    <td valign=top style='padding:0in 0in 0in 0in'>
    <p class=MsoNormal align=center style='text-align:center;mso-line-height-alt:
    0pt'><a href="index.html"><span style='font-size:9.0pt;font-family:"Arial","sans-serif";
    mso-fareast-font-family:"Times New Roman";mso-no-proof:yes'><img border=0
    width=50 height=15 id="_x0000_i1036" src="images/white.gif"></span></a><span
    style='font-size:9.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family:
    "Times New Roman"'><br style='mso-special-character:line-break'>
    <![if !supportLineBreakNewLine]><br style='mso-special-character:line-break'>
    <![endif]><o:p></o:p></span></p>
    </td>
   </tr>
   <tr style='mso-yfti-irow:1;height:86.25pt'>
    <td valign=top style='padding:0in 0in 0in 0in;height:86.25pt'>
    <p class=MsoNormal align=center style='text-align:center'><a
    href="index.html"><span style='font-size:9.0pt;font-family:"Arial","sans-serif";
    mso-fareast-font-family:"Times New Roman";mso-no-proof:yes'><img border=0
    width=628 height=105 id="_x0000_i1035" src="images/logointerior.gif"></span></a><span
    style='font-size:9.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family:
    "Times New Roman"'><o:p></o:p></span></p>
    </td>
   </tr>
   <tr style='mso-yfti-irow:2;height:18.75pt'>
    <td valign=top style='padding:0in 0in 0in 0in;height:18.75pt'>
    <p class=MsoNormal><a href="index.html"><span style='font-size:9.0pt;
    font-family:"Arial","sans-serif";mso-fareast-font-family:"Times New Roman";
    mso-no-proof:yes'><img border=0 width=113 height=20 id="_x0000_i1034"
    src="images/nav/homeoff.gif"></span></a><a href="services.html"><span
    style='font-size:9.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family:
    "Times New Roman";mso-no-proof:yes'><img border=0 width=113 height=20
    id="_x0000_i1033" src="images/nav/servicesoff.gif"></span></a><a
    href="physicians.html"><span style='font-size:9.0pt;font-family:"Arial","sans-serif";
    mso-fareast-font-family:"Times New Roman";mso-no-proof:yes'><img border=0
    width=113 height=20 id="_x0000_i1032" src="images/nav/physicianoff.gif"></span></a><a
    href="education.html"><span style='font-size:9.0pt;font-family:"Arial","sans-serif";
    mso-fareast-font-family:"Times New Roman";mso-no-proof:yes'><img border=0
    width=113 height=20 id="_x0000_i1031" src="images/nav/educationoff.gif"></span></a><a
    href="paforms.html"><span style='font-size:9.0pt;font-family:"Arial","sans-serif";
    mso-fareast-font-family:"Times New Roman";mso-no-proof:yes'><img border=0
    width=113 height=20 id="_x0000_i1030" src="images/nav/patientoff.gif"></span></a><a
    href="policies.html"><span style='font-size:9.0pt;font-family:"Arial","sans-serif";
    mso-fareast-font-family:"Times New Roman";mso-no-proof:yes'><img border=0
    width=114 height=20 id="_x0000_i1029" src="images/nav/policesoff.gif"></span></a><a
    href="contact.html"><span style='font-size:9.0pt;font-family:"Arial","sans-serif";
    mso-fareast-font-family:"Times New Roman";mso-no-proof:yes'><img border=0
    width=113 height=20 id="_x0000_i1028" src="images/nav/contactoff.gif"></span></a><span
    style='font-size:9.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family:
    "Times New Roman"'><o:p></o:p></span></p>
    </td>
   </tr>
   <tr style='mso-yfti-irow:3;height:97.5pt'>
    <td valign=top style='padding:0in 0in 0in 0in;height:97.5pt'>
    <p class=MsoNormal><span style='font-size:9.0pt;font-family:"Arial","sans-serif";
    mso-fareast-font-family:"Times New Roman";mso-no-proof:yes'><img border=0
    width=792 height=91 id="_x0000_i1027"
    src="images/imagebars/patientforms.jpg"></span><span style='font-size:9.0pt;
    font-family:"Arial","sans-serif";mso-fareast-font-family:"Times New Roman"'><o:p></o:p></span></p>
    </td>
   </tr>
   <tr style='mso-yfti-irow:4'>
    <td style='padding:0in 0in 0in 0in'>
    <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0 width=792
     style='width:8.25in;mso-cellspacing:0in;mso-yfti-tbllook:1184;mso-padding-alt:
     0in 0in 0in 0in'>
     <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes;
      height:251.25pt'>
      <td width=145 style='width:108.75pt;padding:0in 0in 0in 0in;height:251.25pt'>
      <p class=MsoNormal><span style='font-size:9.0pt;font-family:"Arial","sans-serif";
      mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p>
      </td>
      <td width=507 valign=top style='width:380.25pt;padding:0in 0in 0in 0in;
      height:251.25pt'>
      <p class=MsoNormal style='margin-bottom:12.0pt;line-height:14.0pt'><span
      style='font-size:9.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family:
      "Times New Roman";color:#58595B'>At your convenience, please download,
      review and complete the applicable patient forms. Please bring them to
      your appointment. <o:p></o:p></span></p>
      <table class=MsoNormalTable border=0 cellspacing=0 cellpadding=0
       width=507 style='width:380.25pt;mso-cellspacing:0in;mso-yfti-tbllook:
       1184;mso-padding-alt:0in 0in 0in 0in'>
       <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes;height:22.5pt'>
        <td width=190 style='width:142.5pt;padding:0in 0in 0in 0in;height:22.5pt'>
        <p class=MsoNormal><span style='font-size:9.0pt;font-family:"Arial","sans-serif";
        mso-fareast-font-family:"Times New Roman"'><a
        href="http://www.critcaremd.com/downloads/WelcomeLetter.pdf"
        target="_blank"><b><span style='color:#024A6F'>Welcome Letter</span></b></a><o:p></o:p></span></p>
        </td>
        <td width=160 style='width:120.0pt;padding:0in 0in 0in 0in;height:22.5pt'>
        <p class=MsoNormal><span style='font-size:9.0pt;font-family:"Arial","sans-serif";
        mso-fareast-font-family:"Times New Roman"'><a
        href="http://www.critcaremd.com/downloads/PatientInformation.pdf"
        target="_blank"><b><span style='color:#024A6F'>Patient Information</span></b></a><o:p></o:p></span></p>
        </td>
        <td style='padding:0in 0in 0in 0in;height:22.5pt'>
        <p class=MsoNormal><span style='font-size:9.0pt;font-family:"Arial","sans-serif";
        mso-fareast-font-family:"Times New Roman"'><a
        href="http://www.critcaremd.com/downloads/PrivacyAgreement.pdf"
        target="_blank"><b><span style='color:#024A6F'>Privacy Agreement</span></b></a><o:p></o:p></span></p>
        </td>
       </tr>
       <tr style='mso-yfti-irow:1;height:22.5pt'>
        <td width=190 style='width:142.5pt;padding:0in 0in 0in 0in;height:22.5pt'>
        <p class=MsoNormal><span style='font-size:9.0pt;font-family:"Arial","sans-serif";
        mso-fareast-font-family:"Times New Roman"'><a
        href="http://www.critcaremd.com/downloads/PulmonaryQuestionaire.pdf"
        target="_blank"><b><span style='color:#024A6F'>Pulmonary Questionnaire </span></b></a><o:p></o:p></span></p>
        </td>
        <td width=160 style='width:120.0pt;padding:0in 0in 0in 0in;height:22.5pt'>
        <p class=MsoNormal><span style='font-size:9.0pt;font-family:"Arial","sans-serif";
        mso-fareast-font-family:"Times New Roman"'><a
        href="http://www.critcaremd.com/downloads/SleepQuestionnaire.pdf"
        target="_blank"><b><span style='color:#024A6F'>Sleep Questionnaire</span></b></a><o:p></o:p></span></p>
        </td>
        <td width=200 style='width:150.0pt;padding:0in 0in 0in 0in;height:22.5pt'>
        <p class=MsoNormal><span style='font-size:9.0pt;font-family:"Arial","sans-serif";
        mso-fareast-font-family:"Times New Roman"'><a
        href="http://www.critcaremd.com/downloads/ConsenttoLeaveorSendMedicalInformation2012.pdf"
        target="_blank"><b><span style='color:#024A6F'>Communication
        Preferences</span></b></a><o:p></o:p></span></p>
        </td>
       </tr>
       <tr style='mso-yfti-irow:2;mso-yfti-lastrow:yes;height:22.5pt'>
        <td width=190 style='width:142.5pt;padding:0in 0in 0in 0in;height:22.5pt'></td>
        <td width=160 style='width:120.0pt;padding:0in 0in 0in 0in;height:22.5pt'></td>
        <td width=200 style='width:150.0pt;padding:0in 0in 0in 0in;height:22.5pt'></td>
       </tr>
      </table>
      </td>
      <td width=140 style='width:105.0pt;padding:0in 0in 0in 0in;height:251.25pt'>
      <p class=MsoNormal><span style='font-size:9.0pt;font-family:"Arial","sans-serif";
      mso-fareast-font-family:"Times New Roman"'>&nbsp;<o:p></o:p></span></p>
      </td>
     </tr>
    </table>
    </td>
   </tr>
   <tr style='mso-yfti-irow:5;mso-yfti-lastrow:yes'>
    <td valign=top style='padding:0in 0in 0in 0in'>
    <p class=MsoNormal align=center style='text-align:center;line-height:16.0pt'><span
    style='font-size:8.0pt;font-family:"Arial","sans-serif";mso-fareast-font-family:
    "Times New Roman";color:#58595B'><a href="index.html"><span
    style='color:#58595B'>Home</span></a> | <a href="services.html"><span
    style='color:#58595B'>Our Services</span></a> | <a href="physicians.html"><span
    style='color:#58595B'>Our Physicians</span></a> | <a href="paforms.html"><span
    style='color:#58595B'>Patient Forms</span></a> | <a href="education.html"><span
    style='color:#58595B'>Patient Education</span></a> | <a href="policies.html"><span
    style='color:#58595B'>Policies</span></a> | <a href="contact.html"><span
    style='color:#58595B'>Contact Us</span></a> | <a href="sitemap.html"><span
    style='color:#58595B'>Site Map</span></a><br>
    274 Union Blvd, Suite 110, Lakewood, CO 80228&nbsp;&nbsp;<strong><span
    style='font-family:"Arial","sans-serif"'>Office:</span></strong>
    303-951-0600&nbsp;&nbsp;<strong><span style='font-family:"Arial","sans-serif"'>Fax:</span></strong>
    303-951-0605<o:p></o:p></span></p>
    </td>
   </tr>
  </table>
  </div>
  </td>
 </tr>
</table>

<p class=MsoNormal><span style='font-size:9.0pt;font-family:"Arial","sans-serif";
mso-fareast-font-family:"Times New Roman"'><script  type="text/javascript">
var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");
document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));
</script><script  type="text/javascript">
try {
var pageTracker = _gat._getTracker("UA-10106096-1");
pageTracker._trackPageview();
} catch(err) {}
</script></span><span style='mso-fareast-font-family:"Times New Roman"'><o:p>&nbsp;</o:p></span></p>

</div>

</body>

</html>