Please fill out the form below to register for the IPF Laser Study.
Prefer to send it by mail? Use this form instead.
Your Name (required)
Your Age (required)
Your Birthdate (required)
Your Address (required: please include country, state and zip code)
Your Email (required)
Your Telephone Number (required)
Date of IPF Diagnosis (required)
Date Biopsy Performed
Have Blood-Oxygen Meter?
What is your current blood-oxygen % level at rest? (required)
Start Date (if you've started)
Dose Utilized (Joules)
Being part of this study requires submission of copies of the results of all Pulmonary Function Tests (PFT’s), and Lung CT scan reports.
* Note that all personal information will be kept confidential *
Please mail copies of PFT’s and CT scan results to:
Andrew Hall DC
PO Box 1100
Twain Harte, CA 95383 (USA)
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