Download the Referral Form

  • OHIP will only cover requests for sleep studies on the order of a physician
  • Referrals for sleep studies are not accepted by other professional bodies. In order to be referred to the facility, a physician currently responsible for the care of the patient must initiate the referral using the steps below
  • Self-referrals are not permitted
  • Referrals are accepted by either fax or mail using the provided sleep laboratory referral forms. Referrals made by telephone are not permitted

The referral form for sleep studies consists of four sections:

Section A
Patient Information / Physician Information

The name, address, phone number(s), date of birth, and Health Card Number (HCN) of the patient to be referred to the facility must be completed.

 

Section B
Physician Information

The names of the requesting, referring, and family physicians, including the requesting physician’s OHIP Billing Number are to be completed in full. The requesting physician must provide a signature and date the request.

 

Section C
Reason(s) For Referral/Pertinent Medical History

Symptoms Leading to Referral

The requesting physician must provide as much information as possible in this section of the referral form. This information includes a diagnosis, pertinent medical history, symptoms leading to referral, current medications, surgical history, CPAP or supplemental oxygen use, and any additional information that may be essential in assessing and providing the correct sleep study for the patient.

In order to prioritize patients based upon the severity of their symptoms, the referring physician must declare the relative level or urgency assigned to the referral.

 

Acceptable Indications For Sleep Study

  • Suspected sleep apnea
  • Snoring accompanied with any other indications
  • Excessive Daytime Sleepiness
  • Witnessed Apneas
  • Suspected Periodic Limb Movement (PLM)/Restless Leg Syndrome (RLS)

All referrals for sleep studies are to be reviewed by the site sleep physician(s) prior to patient booking.