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401 Smith Road, Ottawa, ON K1H 8L1, Canada (613) 7377600 www.cheo.on.ca SLEEP LABORATORY REFERRAL Fax: 6137384865 Patient Identification The focus of the sleep laboratory at present is the evaluation

How to fill out sleep laboratory referral

1. To fill out a sleep laboratory referral, you will need to gather the necessary information and follow the specific instructions provided by the referring healthcare professional or sleep medicine specialist.
2. Start by filling out the patient's personal information, including their full name, date of birth, address, and contact information. This ensures accurate identification and communication throughout the referral process.
3. Include the reason for the referral in detail. This could be symptoms such as excessive daytime sleepiness, loud snoring, or suspected sleep disorders like insomnia, sleep apnea, or restless leg syndrome. Providing specific details helps the sleep laboratory understand the purpose of the referral and tailor the sleep study accordingly.
4. If the referring physician has already performed any preliminary tests or assessments, such as a physical examination, bloodwork, or other diagnostic tests, include these results along with the referral. This gives the sleep laboratory a comprehensive understanding of the patient's medical history and any relevant findings that may influence the future sleep study.
5. Indicate any additional relevant medical conditions or treatments the patient may be undergoing. For example, if the patient has diabetes, hypertension, or is using a continuous positive airway pressure (CPAP) machine, this information can help the sleep laboratory's team provide appropriate accommodations and monitoring during the sleep study.
6. Include any relevant medications the patient is currently taking. Certain medications can impact sleep patterns and may need to be accounted for during the sleep study. It is important for the sleep laboratory to be aware of any medications that could influence the results or require special attention during the study.
7. Specify any particular instructions or preferences for scheduling the sleep study. This could include the patient's availability, any necessary accommodations, or specific preferences the referring physician may have. It is helpful to include any time constraints, such as urgency or specific dates, so the sleep laboratory can prioritize the referral accordingly.
8. Finally, ensure that the referral is signed and dated by the referring physician. This validates the referral and confirms the healthcare professional's recommendation for the sleep study.

Who needs sleep laboratory referral?:

1. Individuals experiencing sleep-related symptoms such as excessive daytime sleepiness, loud snoring, observed pauses in breathing during sleep, or unrefreshing sleep.
2. Individuals suspected of having sleep disorders such as insomnia, sleep apnea, narcolepsy, restless leg syndrome, or parasomnias.
3. Individuals with underlying medical conditions that may contribute to sleep disturbances, such as heart disease, diabetes, obesity, or neurological disorders.
4. Individuals who have tried other treatments or interventions without significant improvement or resolution of their sleep problems.
5. Individuals who require further evaluation or monitoring of their sleep patterns and behaviors to guide the diagnosis and management of their sleep disorders.

For pdfFiller’s FAQs

What is sleep laboratory referral?

Sleep laboratory referral is a formal request from a healthcare provider to refer a patient to a sleep laboratory for diagnostic testing.

Who is required to file sleep laboratory referral?

Healthcare providers such as doctors, sleep specialists, or nurse practitioners are required to file sleep laboratory referrals.

How to fill out sleep laboratory referral?

Sleep laboratory referrals can be filled out by providing patient information, reason for referral, and any relevant medical history.

What is the purpose of sleep laboratory referral?

The purpose of sleep laboratory referral is to diagnose and treat sleep disorders such as sleep apnea, insomnia, or narcolepsy.

What information must be reported on sleep laboratory referral?

Sleep laboratory referral must include patient demographics, referring provider information, reason for referral, and any relevant medical history.

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