Interior Health Polysomnogram Requisition

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  • Create Date January 17, 2023
  • Last Updated January 16, 2023

Interior Health Polysomnogram Requisition

This current version of this eFORM is not fax-enabled.  It has links to Stop-Bang and Epworth Sleepiness Scale (ESS) eFORMS, which you may need to also acquire.  Or you can use the built-in Epworth Scale.

This eFORM requires the ESS measurement:

type="ESS" typeDesc="ESS" typeDisplayName="Epworth Sleepiness Scale" measuringInstrc=""

If unsure how to create this measurement, ask your OSP for assistance.

Attached Files and Latest Versions

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IH_Polysomnogram_Jan15_2023.zipDownload