Refer a Patient

For Physicians

Physician Referral Information

To refer a patient to Neurology & Sleep Medicine Associates, please complete the referral form and submit it to our office by fax or email. Our team will contact the patient to schedule an appointment.

Referral Criteria

We accept referrals for patients with suspected or confirmed sleep and neurological disorders, including:

• + Sleep-related breathing disorders (OSA, central sleep apnea)
• + Insomnia
• + Restless Legs Syndrome & periodic limb movements
• + Narcolepsy & Idiopathic Hypersomnia
• + Parasomnias (sleepwalking, REM sleep behaviour disorder)
• + Circadian rhythm sleep-wake disorders

Online Referral

Referral Form

Complete the form below to submit a referral directly to our office.

Referring Physician

Physician Name *

Clinic / Hospital

Phone *

Fax

Email

Patient Information

Patient First Name *

Patient Last Name *

Date of Birth *

Health Card Number *

Patient Phone

Referral Details

Reason for Referral * Select primary concern... Sleep-related breathing disorder Insomnia Sleep-related movement disorder Excessive daytime sleepiness / Narcolepsy Parasomnia Circadian rhythm disorder Other / General sleep evaluation

Clinical Notes

Urgency Routine Semi-urgent (within 4 weeks) Urgent (within 1 week)

Submit Referral

* Required fields. Our team will confirm receipt within 1 business day.