Referral Form for Pulmonary Function Lab 2026

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  1. Click ‘Get Form’ to open the Referral Form for Pulmonary Function Lab in our editor.
  2. Begin by entering the patient's information, including their name, date of birth (DOB), and gender. Ensure accuracy as this data is crucial for identification.
  3. Fill in the patient's contact details, including home, cell, and work phone numbers. This information helps facilitate communication regarding the referral.
  4. Provide the referring physician's details, including their name, address, office phone, and fax number. This section is essential for follow-up and coordination of care.
  5. In the 'Reason for Referral/Indication' section, check all applicable conditions such as COPD or asthma. This helps prioritize the patient's needs.
  6. Select the tests you are ordering from the list provided. Options include PFT Basic Bundle and others tailored to specific conditions.
  7. Finally, ensure that the referring physician signs the form before submission to validate the referral.

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Your healthcare provider may order pulmonary function tests if you have lung or airway symptoms like cough or shortness of breath, are undergoing surgery or use tobacco products (smoke).
Reply: The silica standards specifically require that PFT be administered by a technician who holds a current certificate from a National Institute for Occupational Safety and Health (NIOSH)-approved spirometry course.
While many patients will see a pulmonologist following a referral by their general practitioner, referrals are not necessary.
94726: This code is used for lung volume measurement, which measures the amount of air in the lungs at different points in the breathing cycle. 94727: This code is used for gas diffusion testing, which measures how well oxygen and carbon dioxide move between the lungs and the blood.
You must have a valid referral from your healthcare provider (GP or a Specialist Doctor), for you to have a lung function test.

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