SLEEP DISORDER CENTER
"FOR A GOOD NIGHT SLEEP"
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Polysomnography CPAP Titration BiLevel Titration MSLT MWT Split Study Sleep Medicine Consult
Snoring Obstructive Sleep Apnea
Narcolepsy Restless Leg Syndrome
Special Instructions: (Using Dental Appliance, On Oxygen, etc.)
Re: Medical Necessity For Polysomnography
To Whom it May Concern:
The above identified patient has symptoms consistent with Obstructive Sleep Apnea, including loud snoring: The physical examination is compatible/suggestive of that diagnosis, also I feel that a polysomnogram (Sleep Study) is absolutely medically necessary to determine the severity of his/her apnea and help decide the treatment which will be necessary to successfully treat this condition.
I agree this constitutes a verbal order authorizing the above medical test.
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