Sleep Study Referral Form

Sleep Is Essential To Life.

Chronic sleep problems affect every aspect of life, from overall wellbeing to serious negative consequences. Inadequate sleep can increase the risks of hypertension, diabetes, obesity, depression, heart attack, and stroke. The long-term effects of sleep deprivation are real.

Clayton Sleep Institute is comprised of Board Certified sleep specialists and scientists, Registered Sleep Technologists, and Registered Respiratory Therapists with years of experience in the field of sleep disorders. CSI is an independent sleep laboratory accredited by the American Academy of Sleep Medicine. We treat the full range of sleep disorders for patients of all ages. We are ready to start treating you.

Referrals for a sleep study must be made by a physician, (MD or DO). To refer a patient for a sleep study, please fax the completed referral form along with:
– Patient demographics
– Office notes that show necessity for a sleep study
– A copy of the patient’s insurance card

CSI will verify insurance benefits before the sleep study and obtain authorization if needed. We will then contact the patient to set an appointment date. Our fax number is 314-645-6446.

Either way, your CSI Patient Care Coordinator will support you in your preparation for your study and help to answer any questions you have.