Physician Referrals

To refer to Sleep Clinic Of America, Citrus County

1. Please Fax in a completed Referral Form to (352) 527-9314 or complete our online referral form below.
2. Sleep Clinic of America will contact the patient to schedule an appointment.

Services Provided:

1. Sleep Consultations
2. Sleep Studies - Including: Diagnostic PSG, MWT, MSLT, CPAP Titration
3. Periodic diagnostic follow-up after initial visit/study.
4. Sleep study scoring center for external sources.

Please contact us at 352-527-6673 with questions, or for more information. Thank you for your referral.

Physician Referral Form


Patient Insurance:


Section A -Reason for Study: Please check all that apply (minimum of TWO).


Symptoms or Medical History


*Choose bolded item if applicable


Yes No

Yes No

Section B- Diagnostic Codes: Please check at least ONE that applies.



Section C:Sleep Study Type

Please Check ONE of the following:


We will make all arrangements for your patient to be set up with CPAP/BiPAP equipment, masks, humidity, accessories, etc. as needed for their treatment of sleep apnea, unless otherwise noted.