Refer Yourself / Refer A Patient

TO REFER YOURSELF:

We do not require a doctor-to-doctor referral, unless your insurance plan requires it. If you suspect you have a sleep disorder and would like to self-refer, please either call the office directly or complete our printable form and return by fax to 817-394-6282.

DOCTORS – TO REFER A PATIENT:

If you’d like to refer your patient for a sleep study only, please complete this form:

SCI referral form – Study Only

If you’d like to refer your patient for a comprehensive sleep evaluation prior to any recommended studies, please use one of the following methods:

  • Complete our printable form and return by fax,
  • Send referrals via Direct Message from your Electronic Health Record system.

–OR–

♦ Send information:

  • Reason for referral
  • Patient contact information/demographics
  • Patient insurance information (primary and secondary)
  • Referring physician contact information, including NPI number
  • Any prior sleep-related or other pertinent medical records

Fax to the attention of “Sleep Referral” at (817) 394-6282, or mail to:

Sleep Referral
2941 Oak Park Circle, Suite 200
Fort Worth, TX 76109

Do you have a child with sleep problems? – We helped Cook Children’s Medical Center begin to provide pediatric sleep medical services in 2007. They are now independent and AASM-accredited. Please refer children with suspected sleep problems to Cook Children’s Medical Center.