West Ottawa Sleep Centre 303 770 Broadview Avenue, Ottawa, Ont., K2A 3Z3 Tel: 6137229900 Fax: 6137229100 Dr. Qasim Alikhan, MD, FRCPC, D, ABSM Dr. Naomi Spitale, MD, FRCPC Dr. Judith Leech, MD, FRCPC,.

How it works
  • Open form

    Open form follow the instructions

  • Easily sign form

    Easily sign the form with your finger

  • Share form

    Send filled & signed form or save

How to fill out the West Ottawa Sleep Centre online

Filling out the West Ottawa Sleep Centre form online is a straightforward process that allows users to provide essential patient information and request services related to sleep studies. This guide will help you navigate each section of the form with clear, step-by-step instructions to ensure you complete it accurately.

Follow the steps to successfully fill out the West Ottawa Sleep Centre form online.

  1. Press the ‘Get Form’ button to access the form and open it in your chosen editing tool.
  2. Begin by filling in the patient information section, which includes your name, OHIP number, address, telephone number, and date of birth.
  3. In the 'Reason for Referral' section, mark all relevant boxes that apply to your situation such as snoring, excessive daytime sleepiness, insomnia, limb movements, parasomnias, or indicate any other reasons.
  4. Proceed to the 'Care Requested' section and select one of the options that best describes the type of service you are requesting, including routine protocol, sleep consultation only, baseline nocturnal sleep study only, or treatment sleep study only.
  5. In the 'Patient Considerations' section, provide any details about previous sleep studies, including the date and institution where they were conducted.
  6. Fill in the 'Patient Characteristics' section with information about your weight (noting if it is over 400 lbs), current CPAP pressure if applicable, and list any medications you are currently taking.
  7. Indicate any auxiliary aids you require by marking the appropriate options, such as oxygen, wheelchair, walker, or cane.
  8. Finally, ensure that the requesting physician's signature and billing number fields are filled out correctly by marking 'Yes' or 'No' as applicable.
  9. Once you have filled out all sections of the form, review the information for accuracy. You can then save your changes, download the document, print it, or share it as needed.

Complete your documents online today for a smoother experience.

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.

Related content

A Study of TAK-994 in Adults With Narcolepsy...

Participants will visit the clinic for a final check-up 2 weeks after their last dose of...

Learn more
STOP, THAT and One Hundred Other Sleep Scales

111 items — Shai Marcu , M.D The Youthdale Child and Adolescent Sleep Centre, ... 1055...

Learn more
Maple Leaf Gardens - Wikipedia

Maple Leaf Gardens is a historic building located at the northwest corner of Carlton...

Learn more
Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

What to expect at a sleep clinic?

We place soft bands around your chest and stomach to measure your breathing. We also put a clip on your finger or earlobe to check the level of oxygen in your blood. We will be with you all night while you sleep and we will use special equipment to check on you from another room.

Please do not bring pagers or cell phones, as these items may interfere with hospital telemetry equipment, disrupt the sleep study and affect your test results. If you must have these devices with you, please make sure they are turned off during testing.

Although you may use mobile phone and internet devices such as cell phones, blackberries, iPhones, and computer laptops prior to your study, you will be asked to turn them off once preparation for your study begins.

The room in the sleep laboratory is more private than most hospital rooms, and is in a separate part of the hospital. If you need anything during the night, you can call out and the technicians will hear you on the intercom. They can also assist you if you need to use the bathroom.

If you need to have a sleep study as an in-patient, you will need to be prepared to stay overnight and in some cases, the following day.

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.

If you believe that this page should be taken down, please follow our DMCA take down process here.

Get West Ottawa Sleep Centre