VERMONT MEDICAL SLEEP DISORDERS CENTER, INC.

Specializing in Sleep diagnostics, Treatment and Education of Sleep Disorders

CORPORATE OFFICE:  139 Pearl Street, Essex Jct., Vermont 05452

PH: 802-878-4445, 800-639-9300, FAX: 802-878-3757

IMPORTANT:   For Quick Scheduling of Patients

Re:  Sleep Studies and Consultations

The enclosed documents are required by insurance companies for prior approval.  The Epworth Sleepiness Scale needs to be filled out by the patient for obtaining prior approval for the scheduling of appointments in a timely manner.

Please fax the following 3 documents to us at the time of the original referral:

1)      Doctors’ notes

2)      Absolute and Relative Indicator

3)      Epworth Sleepiness Scale – completed

Benefit:  Quick scheduling of all patients from the time of referral.

Thank you for your cooperation in this matter.  It is a pleasure to work with you toward improved patient care. 

Thank you,

Ray Paquette, RPSGT

President

S:\VMSDC FILES\Lab Forms\Quick Scheduling of Patients.doc

VERMONT
139 Pearl St., Essex Junction, VT  05452
812 Exchange St., Middlebury, VT  05753
6 Home Health Circle, St. Albans, VT  05478

Phone:     (802)  878-4445
Fax:          (802)  878-3757
Toll Free: (800) 639-9300

NEW YORK
Adirondack Regional Sleep Disorders Center
142 Boynton Avenue, Suite B,
Plattsburg, NY  12901

Phone:     (518)  561-4500
Fax:          (518)  561-4532
Toll Free: (800) 607-8388