Emory referral form 2026

1. Click ‘Get Form’ to open the emory referral form in the editor.
2. Begin by entering the patient's name and date of birth in the designated fields. Ensure accuracy as this information is crucial for identification.
3. Fill in the height and weight or BMI, along with the preferred patient phone number. This data helps in assessing the patient's health status.
4. In the 'Requesting Provider' section, input your contact details, including phone and fax numbers, followed by your printed name and signature.
5. Select the appropriate lab study or office visit options based on patient needs. If a lab study is denied, indicate whether to proceed with a home sleep test or request a peer-to-peer review.
6. Document any specific sleep complaints in the 'History & Physical Exam Notes' section. This information is essential for scheduling and authorizing tests.
7. Complete the diagnosis, history, and symptoms section by checking all applicable boxes. Providing detailed medical history supports test authorization.
8. Lastly, note any special needs or instructions that may be relevant for conducting the study effectively.

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