To initiate your home sleep test, please provide the following information.
If you have a referral or FAA letter, please include it. If not, no worries! Just fill out the form. We’re here to help you get started with your home sleep test.
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I request and consent to the office of Effortless Sleep Diagnostics doing business as ESD Health communicating with me using SMS Text/ Electronic Mail aka Emails and/or Telephone. I understand that such communications may include my personal medical and other sensitive information, and where not feasible cannot be encrypted, may be intercepted or altered by unknown third parties while in transmission, and as such may be viewed or collected by others with access to my SMS Text/Electronic Mail aka Emails and/or Telephone accounts. I understand that I may revoke my consent at any time by contacting the office of Effortless Sleep Diagnostics doing business as ESD Health at 888-977-1048 or email us at [email protected]. HIPAA compliant.
