For Health Professionals
Refer your patient for a physician-interpreted home sleep study or CPAP care. Download the forms below, fill them in on screen or print them, and fax them to the clinic nearest your patient.
Sleep Referral Form
Request a home sleep study, CPAP setup with initial and ongoing titration, or support for a patient who is already on CPAP. Includes a comorbidity checklist and room for your stamp or label.
STOP-BANG Questionnaire
A validated 8-question screen for obstructive sleep apnea risk. Patients can complete it in about a minute in the waiting room. Attach it to your referral to support the request.
Where to send it
Fax the completed form to the location nearest your patient. Not sure which one? Call any of our clinics and we’ll help.
KV (Rothesay)
Referral fax: (506) 847-1882
Phone: (506) 847-5100
154 Hampton Road, Unit 108-109
Rothesay, NB
Riverview
Referral fax: (506) 979-1701
Phone: (506) 405-0700
631 Pinewood Road, Unit 102A
Riverview, NB
Sussex
Referral fax: (506) 434-0637
Phone: (506) 434-7667
20 Kennedy Drive, Unit 6
Sussex, NB
What happens after you refer
- We contact your patient directly to get them started.
- Your patient sleeps at home in their own bed for three nights, wearing a small watch-style device.
- The study is interpreted by a physician, at no cost to your patient, and we forward the results to you.
- If sleep apnea is found and you’ve asked us to, we set up CPAP and handle the mask fitting and ongoing titration.
- We stay with your patient and keep you posted.
Questions about a referral? Call the clinic nearest your patient and our team will help.