Get Canada Sleep Care Solutions Sleep Study & Pft Requisition

Filling out the Canada Sleep Care Solutions Sleep Study & PFT Requisition form online can streamline your experience and ensure that all necessary information is submitted accurately. This guide provides clear, step-by-step instructions to help users complete the form with confidence.

Follow the steps to fill out the Canada Sleep Study & PFT Requisition form.

1. Press the ‘Get Form’ button to access the Canada Sleep Care Solutions Sleep Study & PFT Requisition form. This will allow you to open the document for editing.
2. Begin by selecting the appropriate location for your consultation from the options provided in the form. This ensures that your request is directed to the right facility.
3. In the 'Patient Information' section, fill in your name, date of birth, and telephone number. Ensure accuracy to avoid any communication issues.
4. Provide your residential address in the designated field, making sure to include your street address, city, province, and postal code.
5. Indicate your health card number and its version, along with the expiration date, to confirm your eligibility for services.
6. Next, in the 'Tests Requested' section, specify whether you require a sleep study only, a sleep study with consultation, or other pertinent options.
7. If you have undergone previous sleep studies, mark 'Yes' and provide the dates. If not, select 'No.' Add any relevant comments as needed.
8. For the 'Referring Physician' section, include your physician's name, billing number, contact number, and fax number. A signature may also be required.
9. Clearly state the reason for your referral. Choose from the listed options, such as sleep apnea, insomnia, or other relevant conditions.
10. Complete the 'Past Medical History' and 'Current Medications' sections by providing any relevant medical conditions and listing your medications.
11. If applicable, indicate any special patient needs, including assistance requirements or language preferences.
12. Finally, review your entries for completeness and accuracy. Once confirmed, you can save your changes, download, print, or share the filled form as needed.

Complete your request for the Canada Sleep Study & PFT Requisition form online today.