Get Ubc Sleep Clinic Referral

Filling out the Ubc Sleep Clinic Referral form online is a straightforward process. This guide provides comprehensive instructions to ensure that you accurately complete the required fields and submit the necessary information.

Follow the steps to complete the form successfully.

1. Press the ‘Get Form’ button to obtain the referral form and open it in your preferred editing application.
2. Enter the patient’s contact details accurately, ensuring that names, addresses, and phone numbers are current. Include the date of the referral, along with the full name of the patient and their date of birth.
3. Fill in the patient’s Personal Health Number (PHN) and ensure both day and night phone numbers are provided if applicable.
4. Provide details for the referring doctor, including their specialty, billing number, phone number, and fax number.
5. If there is a Primary Care Physician different from the referring doctor, input their information in the designated section.
6. Indicate suspected sleep disorders by ticking all applicable checkboxes, such as sleep apnea, insomnia, and narcolepsy.
7. Check any prior assessments or treatments the patient has received, including previous assessments at the clinic, prior sleep studies, and overnight oximetry. Ensure to attach relevant documentation.
8. Document the main reason for the referral and include the Epworth Sleepiness Score. This score can be downloaded online.
9. Identify any co-morbid diseases or pregnancy by circling all applicable conditions listed in the form.
10. Determine if the patient has a safety-critical occupation, providing detailed answers for clarity.
11. Review all information for accuracy and completeness before finalizing the form.
12. Submit the completed referral by faxing it to 604-822-9744. Ensure all documents are attached as incomplete referrals will be returned.

Complete your Ubc Sleep Clinic Referral online today for prompt processing.