Service Forms For Doctors

For convenience the necessary forms for referral are available on this site. Please fill in the relevant information needed under the new criteria. FAX or EMAIL the necessary information to Illawarra Sleep Medicine. A reception staff member will contact the patient to arrange a suitable appointment.

What do you need to know?

General practitioners and specialists who want to directly refer patients suspected of having sleep apnoea for a diagnostic home or laboratory based sleep study will need to determine a patient’s eligibility by using the approved assessment tools and meeting the criteria below.


  • STOP-BANG score ≥ 4 OR
  • OSA-50 score ≥ 5


  • Epworth Sleepiness Scale score ≥ 8

Please read information in (For Doctor) prior to requesting a sleep study

Exciting new changes for doctors

Information for Doctors

Home Studies or Attended Studies without prior sleep consultation for patient aged 18 years or older.


Referral Forms

OSA 50 Screening Questionnaire

The OSA 50 screening questionnaire is a brief, four-item OSA screening tool for use in general practice.


Epworth Sleepiness Scale

The Epworth Sleepiness Scale is a scale to help diagnose sleep disorders using a short questionnaire.


Stop-Bang Questionnaire

The STOP-BANG questionnaire is a proven tool that can be used to screen for obstructive sleep apnea (OSA).


ISMC Service Request

You can refer with confidence to ISMC, where you can expect comprehensive management of sleep conditions.