New Patient Intake
Complete our patient intake forms so we can better understand your respiratory needs, equipment, concerns, and care goals before your first consultation.
Let’s Talk Respiratory supports patients through in-home visits in Tampa, Hillsborough, and Pinellas, as well as secure telehealth/video sessions statewide in Florida.
Blank forms may be downloaded publicly. Completed forms that contain health information should only be submitted through a HIPAA-appropriate secure intake system.
How intake works
- Review the booklet. Download the blank intake packet and gather your information.
- Prepare your details. Have your equipment, medication list, and questions ready.
- Use the secure intake process. Submit completed health information only through a HIPAA-appropriate secure system.
- Meet with us. We review your needs before your in-home or telehealth consultation.
Support for patients, caregivers, and complex equipment needs.
We work with adults and families who need respiratory education, equipment support, and one-on-one guidance at home or by secure video.
Conditions we commonly support
- ✓COPD, asthma, and sleep apnea
- ✓Post-hospital recovery and recent exacerbations
- ✓Oxygen therapy and low oxygen concerns
Equipment and support areas
- ✓CPAP, BiPAP, nebulizer, and oxygen equipment
- ✓Ventilator and tracheostomy / trach support
- ✓Caregiver training and troubleshooting
Visit formats
- ✓In-home visits in Tampa, Hillsborough, and Pinellas
- ✓Secure telehealth/video sessions statewide in Florida
- ✓Non-emergency respiratory education and support
Prepare for a smoother first consultation.
- ✓Your medication list, including dose and frequency if available
- ✓Inhalers, oxygen equipment, CPAP/BiPAP, ventilator, or trach supplies
- ✓Recent hospital discharge paperwork or follow-up instructions
- ✓Questions, symptoms, care goals, and equipment concerns
Complete Secure Intake
Because the completed intake forms may contain protected health information, they should be submitted only through a HIPAA-appropriate secure intake system. A regular website contact form or ordinary email should not be used to send completed medical forms.
The public download on this page includes only the blank patient intake booklet. Clinician care plans, SOAP notes, and satisfaction surveys remain separate from the public intake packet.
Download Blank Intake Booklet
Save or print the blank patient packet before your first consultation.
Download Blank Intake BookletComplete Secure Intake
Use the secure process for completed forms containing health information. Do not submit them through ordinary email.
Complete Secure IntakeNeed Help? Contact Us
Get help with downloading forms, understanding next steps, or accessing the secure intake process.
Need Help? Contact UsWe can help you get started.
If you need assistance with the intake process, scheduling, or secure submission access, contact Let’s Talk Respiratory. For privacy, please do not send completed health forms through standard email.