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RESPIRATORY REQUISITION FORM S L EEP APNEA PULMONARY DIAGNOSTICS OXYGEN PATIENT INFORMATION or PATIENT LABEL Last Name: First: Sex: M Address: City: Postal Code: Telephone Number (Daytime): (D.O.B)
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Sleep apnea is a sleep disorder characterized by pauses in breathing or instances of shallow or infrequent breathing during sleep.
Individuals who suspect they may have sleep apnea or have been diagnosed with sleep apnea by a healthcare provider.
To fill out sleep apnea, individuals may need to undergo a sleep study and consult with a healthcare provider for appropriate treatment options.
The purpose of addressing sleep apnea is to improve the quality of sleep, reduce health risks associated with the condition, and enhance overall well-being.
Information such as symptoms, diagnosis, treatment options, and any lifestyle changes recommended by healthcare providers may need to be reported.
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