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The following are forms for patients. Please fill out as completely as possible.

New Patient:

New Patient Paperwork

Authorization for Release of Info
Authorization Form
Patient Data Sheet
Health History Form
Medication Log
Privacy Policy

Sleep Center:

Clinical Sleep Questionnaire
Cataplexy Questionnaire
Instructions
Sleep Diary
Child Sleep Questionnaire

Referrals:

Sleep Order Sheet
Sleep Order Checklist

 

 

 

 

 

 

 

515 SW Horne, Suite 200 • Topeka, Kansas 66606
785-234-5480 • fax 785-234-3124

 

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