METROPLEX PULMONARY & SLEEP CENTER, P.A
4833 Medical Center Drive, Suite 6B McKinney, Texas 75069
Phone: 972- 838-1892 Fax: 972-838-1896 or 972-954-6030

PATIENT HISTORY FORM

Other Hospitalizations:

Current Medications: Please list all medications you are currently taking. We can also make a copy of your medication list if you have it with you.