Get the free SLEEP DISORDER REFERRAL FORM - MedSleep

Mid-sleep Calgary 295 Midpark Way S.E., Suite 300 (Phone) 403-254-6400 Calgary, Alberta, T2X 2A8 (Fax) 403-254-6403 infocalgary medsleep.com www.medsleep.com SLEEP DISORDER REFERRAL FORM Please fax

How to fill out sleep disorder referral form

How to fill out sleep disorder referral form?

1. Start by carefully reading the instructions on the form. Understand what information the form requires and the format in which it should be provided.
2. Begin by providing your personal information such as your name, address, phone number, and date of birth. Some forms may also ask for your social security number or insurance information.
3. Next, provide details about your primary care physician or referring doctor. This includes their name, contact information, and any relevant identification numbers. If you don't have a referral, check if the form allows for self-referral or if you need to consult with a healthcare provider first.
4. Indicate the specific type of sleep disorder you are seeking a referral for. This may include conditions such as sleep apnea, insomnia, narcolepsy, restless leg syndrome, or others.
5. Describe any symptoms or issues you have been experiencing related to your sleep disorder. Be as detailed as possible to ensure accurate diagnosis and appropriate referrals.
6. If you have previously been diagnosed with a sleep disorder or have undergone any sleep studies or treatments, provide this information on the form. This helps to provide a comprehensive medical history and assists the healthcare provider in making informed decisions.
7. If applicable, provide information about any medications you are currently taking for your sleep disorder or any other relevant medical conditions. This includes dosage, frequency, and the name of the prescribing doctor if different from your primary care physician.

Who needs sleep disorder referral form?

1. Individuals experiencing sleep-related symptoms or issues should consider obtaining a sleep disorder referral form. This includes people with persistent trouble falling or staying asleep, excessive daytime sleepiness, loud snoring, interrupted breathing during sleep, or any other signs of a potential sleep disorder.
2. In some cases, primary care physicians may also recommend a sleep disorder referral form for patients they suspect to have a sleep-related condition. This can help to ensure a proper diagnosis, access to specialized care, and appropriate treatment options.
3. If you have received a recommendation or referral from a healthcare provider, they may specifically request that you fill out a sleep disorder referral form to facilitate the process of getting the necessary diagnostic tests and therapies.

Note: It is important to consult with a healthcare professional or your primary care physician before filling out any medical forms, including a sleep disorder referral form. This ensures that you are receiving personalized and accurate guidance based on your specific health needs.

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