We kindly thank you for your referral. Please print this attachment out, complete it, and either send the form with the patient or fax it to our office at (432) 332-6500. If you are the primary care provider, please provide a referral number. Please note that no referral is necessary in most cases, but referred patients are usually seen sooner depending on the provider’s request.

• Mallampati Score
• Referring Providers
• Screening Questionnaire Sleep