Forms & Resources

Downloadable Forms

 

Online Forms

New Patient Registration
New Patient Questionnaire
Follow-up Questionnaire
Email Authorization Form
Contact The Center For Sleep & Wake Disorders

5454 Wisconsin Ave., Suite 1725

Chevy Chase, MD 20815

mail at sleepdoc dot com

Phone: 301-654-1575

Fax: 301-654-5658

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Need some guidance and general information? Check out our comprehensive information and useful links page that covers everything from what is a “good night’s sleep” to links to sleep-related organizations around the world.

Wondering about what payment options we are accepting, late fees, or our list of participating insurance providers? All that information is at your finger tips.

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Contact form for The Center For Sleep and Wake Disorders

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Full Name of Patient:
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In order to comply with Federal regulations regarding the protection of electronic protected health information (ePHI), the Center for Sleep & Wake Disorders requires that all electronic communication with patients be via our secure patient portal unless this email authorization form is signed ahead of time. We can no longer use email to communicate with patients without this document on file. If you have not done so already, please complete this email authorization form so that we may communicate with you via email. Thank you.

The front desk staff answers phone calls between 9:00am and 12 noon, and between 2:00 pm and 4:00 pm. Callers for the front desk outside those hours can leave voicemail messages, which are picked up throughout the day.

*If this is a life-threatening emergency, please do not use this form. Please call 911.*