Patient Questionnaire / HIPPA / PHI / Photo New Patients

*Please complete all listed items on this page.*

FOR NEW PATIENTS & THOSE RETURNING AFTER 3 YEARS

Sleep Study Questionnaire

Fill Out the Questionnaire and Submit Here

HIPAA Policy

Sign and Submit HIPAA Policy Here

PHI Disclosure Form

Fill Out and Submit the PHI Disclosure Form Here

Photos of your driver’s license and insurance cards (front and back)

Please take a photo (by mobile phone)

Email the photos of your driver’s license and insurance cards

Email all photos to info@soundasleeplab.com
On the subject line type your name and date of birth