Below are a number of forms you can select from once you’ve made an appointment for your first visit. Dr Lindsley will let you know which ones she will need. Please download the relevant files, print them and complete. You will bring the completed forms with you to your first visit. You will also be asked to bring a photocopy of the front and back of your insurance card (or the card itself if you do not have access to a photocopy machine).
1. Adult sleep questionnaire
2. Pediatric (to age 18) Sleep Questionnaire
3. Pediatric Home Situation
4. Sleep, Wake and Temperature diaries
5. Insurance Information
6. Three forms having to do with confidentiality (HIPAA).
The first two are for your information. Please read and keep at home for your own records The final form is a signature page. Your signature on the two designated lines indicates you have read and understand each of the first two documents. Please DO bring this with you to your first visit.
7. Consent to Release Information