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I want to be a rock star like Jane Goodall and help the monkeys.
7 yr old Amanda

Sleep Study Referral Form

APPOINTMENT AUTHORIZATION – the information below will be used to schedule or confirm an appointment with Children's Hospital Colorado Sleep Lab. Please fill one form out for each appointment requested.

Type of Study

Contact Information



Medical Information
Indicate size of tonsils

legend: 0 = Can't see, 4 = Kissing