A polysomnogram must be ordered by a clinician. Referring physicians can order overnight polysomnograms by completing a request form and precertification.
Read the Sleep Laboratory Direct Referral Policy (PDF) to find out who is eligible to proceed directly to the sleep lab without being seen in the Sleep Clinic first.
Please fax completed forms to 215-590-2632 or send them to the Sleep Center on the first floor of the Main Hospital. We will review the patient's clinical history and determine if the patient can come directly to the lab without an office visit. We will contact the patient to schedule a polysomnogram or notify that an office visit is required.
To obtain forms or for more information about scheduling, please call 215-590-3703, Monday through Friday between 8:30 a.m. and 5:00 p.m.
You can also download the Sleep Lab Polysomnogram Request Form (PDF).
Precertification is required for an overnight polysomnogram. Ordering physician or department must complete the patient's clinical history and insurance information.
For situations that may require an emergency request for a polysomnogram, the on-call pulmonary fellow can be reached on beeper 10122.