REFERRAL FORM

You may either submit a direct referral form above or download our Referral Form and scan it back to us - info@sliiip.com

After submitting a referral, you will need to schedule a telemedicine consultation.


RELEASE OF MEDICAL INFORMATION

For patients: Please download this document and submit it to the medical records department at your local hospital or hospital you were recently admitted to. This form may also be used to retrieve information from prior pulmonary or sleep specialists to ensure we will not need to repeat tests, unnecessarily. Please be aware some results may not be applicable after a period of time.