Jeffrey S. Garrett, MD, FACP, FACC

"My subspecialty, interventional cardiology, involves new methods of treating circulatory disease. This rapidly developing field includes use of techniques such as atherectomy (physically removing atherosclerotic blockages from blood vessels) and balloon angioplasty (dilating obstructed arteries). In California, I was involved in developing the atherectomy technology. As Associate Director of the Cardiac Catheterization Laboratory at The Western Pennsylvania Hospital, and Clinical Assistant Professor, I am committed to providing complete personalized cardiovascular care to my patients."

Jeffrey S. Garrett, MD, FACP, FACC completed his medical training at the New York University School of Medicine, where he earned his Medical Doctor degree in 1981.

Dr. Garrett trained in Internal Medicine at the New York University Medical Center, completing his training in 1984. He subsequently completed his Cardiology training at the University of California at San Francisco.

His honors include Phi Beta Kappa, Fellowship in the American College of Physicians, and Fellowship in the American College of Cardiology. Dr. Garrett additionally has been awarded of a National Institute of Health Fellowship research grant.

Dr. Garrett is Board Certified in Internal Medicine and Cardiovascular Diseases.

Dr. Garrett is Clinical Assistant Professor of Medicine at the Temple University School of Medicine and at the University of Pittsburgh School of Medicine.

He is a published author, having research interests that include both new medication and new device development.

Dr. Garrett is committed to providing complete, personalized cardiovascular care to his patients.

Abbreviated Curriculum Vitae

• 1977 - Queens College of the City of New York, B.A.
• 1981 - New York University School of Medicine, M.D.
• 1981-1984 - New York University-Bellevue Medical Center: Medical Resident
• 1984-1985 - Cardiovascular Research Institute, University of California, San Francisco: Research Fellow
• 1985-1987 - Clinical Fellow in Cardiology
• 1987-1988 - Instructor in Medicine
• 1998-Present - University of Pittsburgh School of Medicine: Clinical Assistant Professor
• 1984 - American Board of Internal Medicine, Diplomate
• 1989 - Subspecialty of Cardiovascular Diseases, Diplomate
• 1999-2009 - Subspecialty of Interventional Cardiology, Diplomate
   

Fellowships

• Fellow, American College of Physicians
• Fellow, American College of Cardiology

LeRoy Moore, MD, FACC

"My subspecialties include nuclear cardiology, echocardiography, and diagnostic cardiac catherterization. My area of particular interest is nuclear cardiology, which deals with the use of radioisotopes for the non-invasive assessment of coronary circulation and cardiac function.

I enjoy meeting new patients and helping them with their medical conditions and treatments. My goal is to provide the best possible care for my patients."

Abbreviated Curriculum Vitae

• 1976 - Pennsylvania State University, B.A.
• 1981 - Hahnemann Medical College and Hospital, M.D.
• 1981-1984 - Hahnemann University Hospital, Philadelphia, PA: Medical Resident
• 1984-1987 - National Health Service Corps
• 1984-1989 - Geisinger Medical Group
• 1989-1992 - Health Center Hospitals, University of Pittsburgh: Cardiology Fellow
• 1993-Present - University of Pittsburgh School of Medicine: Clincal Assistant Professor
• 1984 - American Board of Internal Medicine, Diplomate
• 1993 - Subspecialty of Cardiovascular Diseases, Diplomate
• 1998 - Certification Council of Nuclear Cardiology
• 2001 - Clinical Assistant Professor of Medicine at Temple University
   

Fellowships

• Fellow, American College of Cardiology

Larry Hurwitz, MD, FACC

Dr. Hurwitz is now retired, effective 12/31/2009

"I have been in the practice of general cardiology since 1973. My special interests are prevention of cardiovascular disease and the rehabilitation of patients with heart disease. I have served in the exercise laboratory in the Montefiore Hospital and am now involved in the Cardiac Rehabilitation Program at the Western Pennsylvania Hospital.

Over the past 20 years I have been committed to medical education and teaching and maintained my academic appointments at the University of Pittsburgh. Most of all, I value my relationships with my patients. Shadyside Cardiology Associates has allowed me to continue to provide quality, comprehensive medical care."

Abbreviated Curriculum Vitae

• 1964 - University of Rochester, B.A.
• 1968 - University of Pittsburgh School of Medicine, M.D.
• 1968-1969 - Montefiore Hospital, Pittsburgh, PA: Medical Intern
• 1969-1970 - Kaiser Foundation Hospital, Oakland, CA: Medical Resident
• 1970-1971 - Montefiore Hospital, Pittsburgh, PA: Medical Resident
• 1971-1973 - George Washington University Hospital, Washington, DC: Cardiology Fellow
• 1973-1988 - University of Pittsburgh School of Medicine: Clinical Assistant Professor
• 1988-Present - Clinical Associate Professor
• 1972 - American Board of Internal Medicine, Diplomate
• 1974 - Subspecialty of Cardiovascular Diseases, Diplomate
   

Fellowships

• Fellow, American College of Cardiology
• Fellow, Clinical Council of the American Heart Association

Surendra K. Sethi, MD

Doctor Surendra K. Sethi came to Butler in 1973 after completing his cardiology fellowship at Montefiore and Allegheny General Hospitals. He is board certified in Internal Medicine and Cardiology. Doctor Sethi is a fellow in both the American College of Cardiology and the Council of Clinical Cardiology of the American Heart Association.

Doctor Sethi is a former member of the Board of Directors of Butler Memorial Hospital. As an active member of the medical staff and former chairman of the Department of Cardiology he had been very instrumental in the continued development and expansion of the cardiology program at Butler Memorial Hospital. When he first came to Butler in 1973 the Cardiology Department consisted only of an EKG machine and a part-time employee. The current Cardiology Department is a comprehensive diagnostic facility including nuclear cardiology, stress testing, echocardiography, cardiac catheterizations, both diagnostic and interventional, and open-heart surgery.

Doctor Sethi practices general cardiology with interests in interventional cardiology, nuclear imaging of the heart and CT angiography of the coronary arteries.

Medical Services

Shadyside Cardiology Associates offers a variety of medical services including, but not limited to:

• Invasive & Interventional Cardiology
  • Cardiac Catheterization/Coronary Angiography
  • Balloon Angioplasty & Stent Placement
  • Atherectomy- Directional & Rotational
• Common Conditions We Treat
  • Coronary Artery Disease
  • Valvular Heart Disease
  • Arrythmias
  • Cardiomyopathy
  • Hyperlipodemia
  • Hypertension
  • Heart Failure
  • Peripheral Vascular Disease
• Clinical Cardiology
  • Cardiac Consultation
  • Arrhythmia Management
  • Pacemaker Management (run a pacemaker clinic)
  • Cholesterol Management
  • AICD
• Noninvasive Diagnostic Cardiology
  • Echocardiography
  • Holter and Event Monitoring
  • Tilt table Testing
  • Carotid Ultrasound
  • Exercise Stress Testing
  • Cardiac CT
  • Cardiac CT Angiography
• Nuclear Imaging
  • Cardiolite® Stress Testing
  • MUGA scans
  • Thallium Studies
• Electrophysiology
  • Implantable Cardiac Difibrillator – Device implantation
  • Pacemaker Implantation
  • Cardiac ablations
• Cardiac Rehabilitation
  • Phase II and III
• Cardiac Research

Welcome

We welcome you as a patient to our practice and look forward to helping you achieve your optimal cardiovascular health. This web page will introduce you to our group and help you understand our methods of practice.

Shadyside Cardiology Associates is an independent group of medical specialists who provide comprehensive cardiovascular care for office and hospital patients. Each of the physicians in our group has acquired specialized skills through advanced training. Your individual condition may require the attention of more than one member of our group. By working as a team with your primary physician, we combine our skills to diagnose and treat all types of cardiovascular disorders. Although you may be seen by more than one member of the group, we make every effort to deliver personalized professional services to each of our patients.

Please feel free to ask us questions and talk to us about any of your concerns. If your doctor is not available during office hours, your message may be forwarded to another member of the group. After normal office hours, the answering service will forward all messages to your doctor or the physician on call. Your call will be returned at the earliest opportunity.

Overview » Get Prepared » Diagnostic Tests

Exercise Stress Test

The purpose of this test is to learn whether physical exertion produces any abnormal symptoms or electrocardiographic changes. This information is valuable in helping to determine whether you have an abnormality of the heart. The test also enables your doctor to evaluate the severity of your symptoms and/or your response to treatment. This information is very useful in formulating and guiding your treatment regimen.

Intravenous Dipyridamole Stress Test

This is a pharmacologic stress test using intravenous Dipyridamole (Persantine) will be performed since your physician feels you could not adequately complete an exercise stress test. The purpose of the test is to diagnose possible underlying coronary artery disease or to quantify the extent of known disease.

Overview » Common Requests » Become a Patient

Welcome! We'd like to take this opportunity to welcome you to our practice and to thank you for choosing our practice. We are constantly striving to make our patients' visits more efficient. We invite you to begin your new patient registration as soon as you'd like by following these directions:

Need help viewing, filling out, or printing these forms?

We encourage you to take a look at our PDF Helper Page.

1. Print and Fill out the Patient Registration Form

This can be downloaded directly from this website. Please print, and fill out:

Patient Registration Form

2. Print and Fill out the Medical History Form

This form helps us understand the nature of your current condition:

Medical History Form

3. Prepare for your Office

Visit In addition to completing the above forms, we will also require the following information for your fist visit:

• Driver's License or Other Valid Government-Issued Photo Id
• Insurance card and any co-payment due for visit
• If applicable, any referral form
• If applicable, any X-Rays, MRI Films, CT Scans, or EMG
• If applicable, any pertinent medical history such as lab results

4. Get Directions to Our Office

Visit our Locations page to see a map of our office and get personalized driving directions.

5. We Look Forward to Seeing You!

Evaluation of patients new to the practice will be facilitated by review of previous medical records. Patients are requested to forward this information to our office before their initial visit.

Please arrive 20 minutes early if you have not yet filled out these forms. If you have completed forms with you, you only need to check in with the reception desk 5 minutes before your scheduled appointment.

Thank you for your assistance completing this information. We look forward to seeing you on the day of your appointment!

Do You Need to See a Cardiologist?

You should see a cardiologist if you answer yes to any of the following questions:

• Have you had chest pain, shortness of breath, or palpitations (fluttering in your chest)?
• Do you have any risk factors for heart disease: High Blood Pressure, Diabetes, Hyperlipidemia, Obesity or Family Hisory?
• Have you been told of having a heart murmur?
• Do your legs hurt when you walk?
• Do you become dizzy or have your ever fainted (passed out)?
   

If you have answered yes to any of these questions, see a cardiologist or contact us.

Overview » Common Requests » Renew RX

When you call for prescription refills, please have available the name and dosage of the medication, as well as your pharmacy's phone number. For certain medications, your doctor may request an appointment before refilling the prescription. A narcotic will never be prescribed over the phone.

Overview » Common Requests » Pay Your Bill

We participate in Medicare, Highmark Blue Cross Blue Shield and many commercial and managed care plans. For your convenience, our office will submit your claim directly to your insurance company provided we have the correct insurance information. Many insurance companies do not pay the bill in full and there may be a portion of the bill that will be your responsibility. You will be responsible for any co-payments, deductibles or any other allowable balances not paid by your insurance company. Payments can be made by cash, check, or credit card.

If your managed care plan requires pre-certification for specialty services, including echocardiography and nuclear stress test, it is your responsibility to see that these services are authorized. If pre-certification is required and not obtained, you may be responsible for your entire bill.

Please remember, the responsibility for payment for services remains with you. Our billing office can be reached at (412) 682-2100 extensions 105 and 139 to answer any questions you may have regarding your account.

Overview » Good To Know » Stress Test Info

A cardiac stress test is a medical test that is performed to evaluate arterial blood flow to the heart muscle during exercise, as compared to blood flow while at rest.

The stress test helps your doctor find out how well your heart handles work. As your body works harder during the test, it requires more oxygen so the heart must pump more blood. A stress test can show if the blood supply is reduced in the arteries that supply the heart. It also helps doctors know the kind and level of exercise appropriate for a patient.

Your physician may recommend a stress test for various reasons:

• To diagnose coronary artery disease.
• To diagnose a possible heart-related cause of symptoms such as chest pain, shortness of breath, or lightheadedness.
• To determine a safe level of exercise for you.
• To check the effectiveness of procedures done to improve coronary artery circulation in patients with coronary artery disease.
• To predict the risk of dangerous heart-related conditions such as a heart attack.

The American Heart Association and the American College of Cardiology recommends EKG treadmill testing as the first choice for patients with medium risks of coronary artery disease based upon the risk factors of smoking, family history of coronary disease, hypertension, diabetes, and high cholesterol.

If you have risk factors for heart disease, a stress test can help prevent a heart attack.

Contact your physician or one of our cardiologists to learn more.

Overview » Good To Know » Ejection Fraction

The Ejection Fraction, or EF for short, is one of the most important numbers to know about your heart health.

Recent research shows that patients who have an ejection fraction of 40% or below are at risk for a dangerously fast heart rhythm and sudden cardiac arrest. Sudden cardiac arrest is a leading cause of death in the United States.

To help prevent sudden cardiac arrest, and to improve the quality of care for high-risk patients, it is important for all patients to “know your EF”.

If you have heart disease, or risk factors for heart disease, it is important to have your ejection fraction measured regularly, the same way that you have your blood pressure and cholesterol checked regularly. The ejection fraction is one of the ways that doctors classify the type and severity of heart failure and damage to the heart muscle.

Your doctor may prescribe medications, recommend lifestyle adjustments, and suggest other therapies depending on your ejection fraction.

If you have an ejection fraction measured to be between 50% and 75%, your heart has normal pumping ability.

If you have an ejection fraction measured between 36% and 49%, your heart’s pumping ability is below normal.

If your ejection fraction is measured to be 35% and below, your heart’s pumping ability is low and you may be at risk for sudden cardiac arrest.

If you have experienced any of the following, you should know your EF:

• Heart attack
• Coronary artery bypass surgery
• Coronary artery stent implantation
• Coronary angioplasty
• Palpitations
• Sudden loss of consciousness
• Fainting
• Dizziness
• Family history of sudden cardiac arrest
• Risk factors for heart disease such as diabetes, hypertension, hyperlipidemia, smoking, and family history

If you have answered yes to one or more of the above, you should know your EF.

Your ejection fraction can be measured by ultrasound. This is commonly called echocardiography or “echo”. This is a simple and painless test, which can be done right in our office. By using ultrasound, measurements are taken of the heart and with these measurements, the pumping function of the heart is calculated.

If you want to know your ejection fraction, contact your physician or one of our cardiologists.

Overview » Good To Know » FAQ's

We often hear many of the same questions in the course of practice. View some of the most common ones below:

Do you know your LDL?

 

Are you at risk for sudden cardiac death?

 

Do you suffer from high blood pressure?

 

Privacy Policy

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

If you have any questions about this Notice, please contact our Privacy Officer at the number listed at the end of this Notice.

Each time you visit a healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, a plan for future care or treatment, and billing-related information. This notice applies to all of the records of your care generated by your health care provider.

Our Responsibilities
Shadyside Cardiology Associates, P.C. is required by law to maintain the privacy of your health information and to provide you with a description of our legal duties and privacy practices regarding your health information. The current Notice will be posted in the main waiting and sub-waiting areas and on our website at www.westpenncardio.com. The notice will include the effective date. In addition, we will make our best effort to provide you with a copy of this notice that we request you acknowledge with your signature.

We are required by law to abide by the terms of this Notice and notify you if we make changes to this Notice, which may be at any time. Changes to the Notice will apply to your medical information that we already maintain as well as new information received after the change occurs. If we change our Notice, it will be posted in the main waiting and sub-waiting areas and on our website at www.westpenncardio.com. You may also request that a revised Notice be sent to you in the mail or you may ask for one at your next appointment or appropriate visit. This Notice will also serve to advise you as to your rights with regard to your medical information.

How We May Use and Disclose Medical Information About You.

The following categories describe examples of the way we use and disclose medical information:

1. For Treatment: We may use medical information about you to provide, coordinate and manage your treatment or services. We may disclose medical information about you to other doctors, nurses, technicians (e.g. clinical laboratories or imaging companies), medical students, or other personnel who are involved in your care. We may communicate your information either orally or in writing by mail or facsimile.
   
   We may also provide a subsequent healthcare provider with copies of various reports that should assist him or her in treating you. For example, your medical information may be provided to a physician to whom you have been referred so as to ensure that the physician has appropriate information regarding your previous treatment and diagnosis.
    
2. For Payment: We may use and disclose medical information about your treatment and services to bill and collect payment from you, your insurance company or a third party payer. For example, we may need to give your insurance company information before it approves or pays for the health care services we recommend for you.
    
3. For Health Care Operations: We may use or disclose, as needed, your health information in order to support our business activities. These activities may include, but are not limited to quality assessment activities, employee review activities, licensing, legal advice, accounting support, information systems support and conducting or arranging for other business activities. In addition, we may also call you by name in the waiting room when your physician is ready to see you. We may use or disclose your protected health information, as necessary, to contact you to remind you of your appointment by telephone or reminder card.
    
4. Business Associates: There are some services provided in our organization through contracts with business associates. Examples include billing and collections, sfotware support and quality assurance. If these services are contracted, we may disclose your health information to our business associate so that they can perform the job that we have asked them to do and bill you or your thrid-party payer for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information through a written contract.
    

Other Permitted and Required Uses and Disclosures That May Be Made With your Consent, Authorization or Opportunity to Object

We also may use and disclose your health information as set forth below. You have the opportunity to agree or object to the use or disclosure of all or part of your health information in these instances. If you are not present or able to agree or object to the use or disclosure of the health information (such as in an emergency situation), then your clinician may, using professional judgement, determine whether the disclosure is in your best interest. In this case, only the information that is relevant to your health care will be disclosed.

1. Individuals Involved in Your Care or Payment for Your Care: Unless you object, we may release medical information about you to a friend or family member who is involved in your medical care or who helps to pay for your care. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
    
2. Future Communications: We may communicate to you via newsletters, mailings or other means regarding treatment options, information on health-related benefits or services; to remind you that you have an appointment for medical care; or other community based initiatives in which our facility is participating. If you are not interested in receiving these materials, please contact our Privacy Officer.
    

Other Permitted and Required Uses and Disclosures That May Be Made Without Your Authorization or Opportunity to Object

We may use or disclose your health information in the following situations without your authorization or without providing you with an opportunity to object. These situations include:

1. As required by law. We may use and disclose health information to the following types of entities, including but not limited to:
   • Food and Drug Administration
   • Public Health or Legal Authorities charged with preventing or controlling disease, injury or disability
   • Correctional Institutions
   • Workers Compensation Agents
   • Organ and Tissue Donation Organizations
   • Military Command Authorities
   • Health Oversight Agencies
   • Funeral Directors, Coroners and Medical Directors
   • National Security and Intelligence Agencies
   • Protective Services for the President and Others
   • Authority that receives reports on abuse abuse or neglect
2. Law Enforcement/Legal Proceedings: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.
    
3. State-Specific Requirements: Many states have requirements for reporting including population-based activities relating to improving health or reducing health care costs.

Your Health Information Rights

Although your health record is the physical property of the Shadyside Cardiology Associates, P.C. that compiled it, you have the right to:

1. Inspect and Copy: You have the right to inspect and copy medical information that may be used to make decisions about your care. We ask that you submit these requests in writing. Usually, this includes medical and billing records, but does not include psychotherapy notes or information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review. Requests for access to and copies of your medical information must be submitted to Shadyside Cardiology Associates, P.C. in writing. The practice may charge for copies of the medical record in compliance with charges established under Pennsylvania state law.
    
2. Amend: If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information by submitting a request in writing. You have the right to request an amendment for as long as we keep the information. We may deny your request for an amendment and if this occurs, you will be notified of the reason for the denial.
    
3. An Accounting of Disclosures: You have the right to request an accounting of our disclosures of medical information about you except for certain circumstances, including disclosures for treatment, payment, health care operations or where you specifically authorized a disclosure. Shadyside Cardiology Associates, P.C. will provide the first accounting to you in any 12-month period without charge. The cost for subsequent requests for an accounting within the 12-month period will be $10.00. We ask that you submit these requests in writing.
    
4. Request Restrictions: You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a procedure that you had. We ask that you submit these requests in writing.
   
   We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to privde you with emergency treatment.
    
5. Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. We will agree to the request to the extent that it is reasonable for us to do so. For example, you can ask that we use an alternative address for billing purposes. We ask that you submit these requests in writing.
    
6. A Paper Copy of This Notice: You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice eletronically, you are still entitled to a paper copy of this notice.
    

To exercise any of your rights, please obtain the required forms from the Privacy Officer and submit your request in writing.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us by calling (412)682-2100 and asking for the Privacy Officer or by contacting the Secretary of the Federal Department of Health and Human Services. All complaints must also be submitted in writing. you will not be penalized for filing a complaint.

Other Uses of Medical Information

Other uses and disclosures of medical information not covered by this Notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. However, we are unable to take back any disclosures we have already made with your permission and we are required to retain our records of the care that we provided to you.

Privacy Officer: the Executive Director
Telephone Number: (412) 682 - 2100

Accepted Insurances

We participate in Medicare, Blue Shield, and most managed care plans. For Keystone, SelectBlue and SecurityBlue some of our physicians serve a primary care physicians as well as specialists.

We try to simplfy the preparation of insurance claims and hold down costs which are unrelated to the delivery of quality medical care. For your convenience, our office will submit all your insurance claim forms at no charge to you. Some insurance companies pay fixed allowances for certain procedures and others pay a percentage of the charge.

It is your responsibility to pay any deductible amount, co-insurance or any other allowable balance not paid by your insurance company. You can help us by paying at the time of each office visit. Other arrangements can be made, depending on special circumstances. Please feel free to talk to our insurance clerk about any questions or concerns you may have.

If your managed care plan requires pre-certification for a specialist's service, you must inform our office staff. Please remember to bring your referral form with you. If pre-certification is required and not obtained, you may be responsible for your entire bill.

How to Use the PDF Files on Our Site

How do I view PDF files?
You'll need to download and install Adobe Reader(opens in a new tab). Don't worry, though. It only takes a minute and it's free!

Can I fill these forms out on my computer?
Possibly. Adobe Reader might (or might not) let you fill these forms out on your computer. But keep in mind that Adobe Reader won't let you save the forms after you've filled them out; you'll only be able to print them.

So what's the best way to use these forms?
Ideally, you could fill the form out on your computer and then print it. But before filling out the entire form, try filling out just a few fields and then printing to see if it works. If the form printed with the information you filled out, fill out the entire form and then print!

If the form wasn't able to print with the information you wrote out, then you'll just have to fill it out by hand as you would if in our office directly.

I'm confused. Just tell me something simple.
If all else fails, just follow these directions:

1. Download Adobe Reader(opens in a new tab)
2. Click on the form you want to open
3. Print the form

Affiliated Hospitals

We are proudly affiliated with the following hospitals:

Shadyside Hospital(opens in a new tab)
5230 Centre Avenue
Pittsburgh, PA 15232
(412) 623-2121
 

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The Western Pennsylvania Hospital(opens in a new tab)
4800 Friendship Avenue
Pittsburgh, PA 15224
(412) 578-5000
 

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Mercy Hospital(opens in a new tab)
1400 Locust Street
Pittsburgh, PA 15219
(412) 232-8111
 

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Meyersdale Community Hospital
200 Hospital Dr.
Meyersdale, PA 15552
(814) 634-5911

 

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Butler Memorial Hospital(opens in a new tab)
911 E. Brady St.
Butler, PA 16001
(724) 283-6666

 

Overview » Patient Forms

New Patient?

Be sure to check out our step-by-step instructions for getting registered!

We encourage you to download, print, and fill out our patient forms prior to your office visit.

Most Common Forms

Patient Registration Form(opens in a new tab)

Comprehensive Patient History Form(opens in a new tab)

Sleep Apnea Checklist(opens in a new tab)

Medical Records Release Form(opens in a new tab)

How do I know which forms I'll need?

That depends on for what you'll be seeing us. If you have any questions, don't hesitate to contact us!

Need help viewing, filling out, or printing these forms?

We encourage you to take a look at our PDF Helper Page.