Patient Referral Form

Start your journey to a better sleep. Simply print and fill out the form below. Then take this form to your doctor or bring it to the closest Snore MD clinic.

Download Form:

Patient Referral Form for Greater Vancouver Locations: Vancouver/Broadway, Burnaby, North Vancouver, North Van/Parkgate, Ladner, Port Coquitlam, Surrey/Panorama, Langley, Walnut Grove, Maple Ridge, Abbotsford, Mission, and Gibsons Clinics

Patient Referral Form for Kelowna, West Kelowna, Kamloops, Prince George and Fort St. John Clinics

Patient Referral Form for Victoria Clinic

Patient Referral Form for Lethbridge Clinic

Better Sleep For Canadians 100pxW.jpg