PATIENT FORMS AND INFORMATION



WHAT TO BRING TO YOUR APPOINTMENT



Insurance Card
Copy of Drivers License/Photo ID
A list of current prescriptions or over-the-counter medications you are taking
Your co-pay/deductible (if applicable)
New Patient Forms Completed





 

PATIENT FORMS



For your convenience, Sleep Medicine Specialists of South Florida provides you with downloadable patient forms that you can complete prior to your visit. Please take the time to complete the necessary forms listed below online, print out the form and bring it with you to your appointment.



PACKAGE FORMS
Adult Patient Package
Minor Patient Package

PACKAGE FORMS - Español
Paquete completo paciente adulto
Paquete completo paciente menor de edad

INDIVIDUAL FORMS
Acknowledgement of Receipt of NPP
Adult Patient Demographics Form
Arbitration Agreement Form
Consent to Treatment Form
Minor Patient Demographics form
Patient History Form
Patient Questionnaires

INDIVIDUAL FORMS - Español
Acuerdo de arbitraje
Consentimiento para el tratamiento
Cuestionarios para el paciente
Demografica del paciente adulto
Demografica del paciente menor de edad
Historia medica del paciente
Reconocimiento de recibo de NPP

INSURANCES ACCEPTED