Service Request Form

Request our Service Request Form (prescription)

Fax the completed form to (877) 855-6227 or email orders@sleepdr.com

  • In-center Sleep Study
  • Home Sleep Apnea Testing (HST)
  • CPAP Device Set-up
  • CPAP replacement supplies

The form includes the CPT codes for services, including pediatric studies

Download our Service Request Form