We have prepared a convenient Sleep Referral Form, for the use of physicians who are referring patients to 1st Class Sleep Diagnostics, Inc. They can fill out this form and then fax it to us.

If you are a physician, or work in a doctor's office, print out the Sleep Study Order form below and fill it out for your referral patients.

If you are a patient going to visit your physician, print out the Sleep Referral Form below and bring it on your visit. If your physician feels you need a sleep consultation or sleep study, he or she can fill out the form and fax it to us.

If you are a patient who is self-referring (contacting 1st Class Sleep Diagnostics, Inc directly), you can simply make an appointment for a sleep medicine consultation with one of the doctors. You do not need to print out the form below. We have other forms for you to fill out when you visit our office.

Click on the link below to view the full-size Sleep Referral Form in Adobe PDF format. Then use the Print feature on your Adobe Reader window to print it.

Adobe Acrobat reader is required to view this form. (If you do not have Acrobat Reader, you can download it free of charge here.)