{"id":2496,"date":"2018-08-16T16:55:27","date_gmt":"2018-08-16T06:55:27","guid":{"rendered":"https:\/\/sleepandlungcare.com.au\/?page_id=2496"},"modified":"2026-10-17T14:54:47","modified_gmt":"2026-10-17T03:54:47","slug":"online-referrals","status":"publish","type":"page","link":"https:\/\/sleepandlungcare.com.au\/vi\/online-referrals\/","title":{"rendered":"Chuy\u1ec3n kh\u00e1m tr\u1ef1c tuy\u1ebfn"},"content":{"rendered":"<div data-elementor-type=\"wp-page\" data-elementor-id=\"2496\" class=\"elementor elementor-2496\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-316f2023 pbmit-col-stretched-none pbmit-cursor-color-blackish-color pbmit-bg-color-over-image elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"316f2023\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-1bb7a9cf pbmit-bg-color-over-image\" data-id=\"1bb7a9cf\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3366fb0b elementor-widget elementor-widget-text-editor\" data-id=\"3366fb0b\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h1 style=\"text-align: center;\">Chuy\u1ec3n kh\u00e1m tr\u1ef1c tuy\u1ebfn d\u00e0nh cho b\u00e1c s\u0129 gia \u0111\u00ecnh<\/h1><p style=\"text-align: center;\"><strong>X\u00e9t nghi\u1ec7m ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p v\u00e0 kh\u1ea3o s\u00e1t gi\u1ea5c ng\u1ee7 t\u1ea1i nh\u00e0 \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n \u0111\u01b0\u1ee3c Medicare thanh to\u00e1n to\u00e0n b\u1ed9 (bulk billed) khi c\u00f3 gi\u1ea5y gi\u1edbi thi\u1ec7u c\u00f2n hi\u1ec7u l\u1ef1c. Ph\u00ed kh\u00e1m v\u00e0 m\u1ecdi chi ph\u00ed kh\u1ea3o s\u00e1t gi\u1ea5c ng\u1ee7 t\u1ea1i b\u1ec7nh vi\u1ec7n \u0111\u01b0\u1ee3c t\u00ednh ri\u00eang; b\u1ed9 ph\u1eadn l\u1ec5 t\u00e2n s\u1ebd gi\u1ea3i th\u00edch c\u00e1c kho\u1ea3n ph\u00ed \u00e1p d\u1ee5ng tr\u01b0\u1edbc khi \u0111\u1eb7t l\u1ecbch.<\/strong><\/p><p class=\"translation-block\">Bi\u1ec3u m\u1eabu n\u00e0y d\u00e0nh cho c\u00e1c b\u00e1c s\u0129 gi\u1edbi thi\u1ec7u. B\u1ec7nh nh\u00e2n \u0111\u00e3 c\u00f3 gi\u1ea5y gi\u1edbi thi\u1ec7u n\u00ean d\u00f9ng <a href=\"https:\/\/sleepandlungcare.com.au\/vi\/upload-your-referral\/\">T\u1ea3i gi\u1ea5y gi\u1edbi thi\u1ec7u l\u00ean<\/a>.<\/p><p><p class=\"salc-form-note salc-notice\" data-no-translation data-no-dynamic-translation lang=\"vi\" dir=\"ltr\">M\u1eabu gi\u1edbi thi\u1ec7u n\u00e0y d\u00e0nh cho b\u00e1c s\u0129 gi\u1edbi thi\u1ec7u v\u00e0 \u0111\u01b0\u1ee3c tr\u00ecnh b\u00e0y b\u1eb1ng ti\u1ebfng Anh.<\/p><div class=\"salc-form-en\" data-no-translation data-no-dynamic-translation lang=\"en-AU\" dir=\"ltr\"><style type=\"text\/css\">.super-form:not(.super-initialized) *:not(.super-load-icon) { visibility: hidden !important; }<\/style><div id=\"super-form-3621\" style=\"margin:0px 0px 0px 0px;\" class=\"super-form super-form-3621  super-default-squared super-field-size-medium\" data-hide=\"true\" data-overlay=\"true\" data-disable-enter=\"true\" data-field-size=\"medium\"><span class=\"super-load-icon\"><\/span><form tabindex=\"0\" autocomplete=\"on\" enctype=\"multipart\/form-data\" action=\"\"><input type=\"hidden\" name=\"sf_nonce\" value=\"\" \/><input type=\"hidden\" name=\"super_create_nonce\" value=\"0c5cc5b7df\" \/><input type=\"text\" name=\"super_hp\" size=\"25\" value=\"\" \/><div class=\"super-shortcode super-field super-hidden\"><input class=\"super-shortcode-field\" type=\"hidden\" value=\"3621\" name=\"hidden_form_id\" \/><\/div><div class=\"super-shortcode super-field super-checkbox super-has-only-label   super-ungrouped   display-vertical\"><div class=\"super-label super-bottom-margin\">Referral priority<\/div><div class=\"super-field-wrapper\"><div class=\"super-items-list\"><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"checkbox\" value=\"URGENT\" \/><div>URGENT \u2013 review within 48 hours requested (suspected lung cancer or lung mass, or rapidly worsening symptoms)<\/div><\/label><\/div><input class=\"super-shortcode-field\" type=\"hidden\" name=\"urgent\" value=\"\" data-oname=\"urgent\" data-email=\"Priority:\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_full super-column grid-level-0 column-number-1 first-column\"><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_half super-column grid-level-1 column-number-1 first-column\"><div class=\"super-shortcode super-field super-text   super-ungrouped\"><div class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"patient_first\" data-oname=\"patient_first\" data-validation=\"empty\" data-email=\"First name:\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" placeholder=\"Patient first name(s)*\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_half super-column grid-level-1 column-number-2\"><div class=\"super-shortcode super-field super-text   super-ungrouped\"><div class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"patient_surname\" data-oname=\"patient_surname\" data-validation=\"empty\" data-email=\"Surname:\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" placeholder=\"Patient surname*\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><\/div><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_half super-column grid-level-1 column-number-1 first-column\"><div class=\"super-shortcode super-field super-text   super-ungrouped\"><div class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"address\" data-oname=\"address\" data-validation=\"empty\" data-may-be-empty=\"true\" data-email=\"Address:\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" placeholder=\"Address\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><div class=\"super-shortcode super-field super-text   super-ungrouped\"><div class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"phonenumber\" data-oname=\"phonenumber\" data-validation=\"phone\" data-email=\"Phone\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" placeholder=\"Phone*\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_half super-column grid-level-1 column-number-2\"><div class=\"super-shortcode super-field super-text   super-ungrouped\"><div class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"name_2\" data-oname=\"name_2\" data-message=\"Please enter the date of birth as dd\/mm\/yyyy.\" data-validation=\"empty\" data-email=\"Date of Birth:\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" placeholder=\"Date of Birth* (dd\/mm\/yyyy)\" \/><\/div><div class=\"super-error-msg\">Please enter the date of birth as dd\/mm\/yyyy.<\/div><div class=\"super-empty-error-msg\">Please enter the date of birth as dd\/mm\/yyyy.<\/div><\/div><\/div><\/div><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_half super-column grid-level-1 column-number-1 first-column\"><div class=\"super-shortcode super-field super-checkbox   super-ungrouped   display-vertical\"><div class=\"super-field-wrapper\"><div class=\"super-items-list\"><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"checkbox\" value=\"Consultation with a Specialist Physician\" \/><div>Consultation with a Specialist Physician<\/div><\/label><\/div><input class=\"super-shortcode-field\" type=\"hidden\" name=\"option\" value=\"\" data-oname=\"option\" data-email=\"Consultation with a Specialist Physician\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><div class=\"super-shortcode super-field super-checkbox super-has-only-label   super-ungrouped   display-vertical\"><div class=\"super-label super-bottom-margin\">Sleep Study<\/div><div class=\"super-field-wrapper\"><div class=\"super-items-list\"><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"checkbox\" value=\"Hospital based sleep study (privately insured patients)\" \/><div>Hospital-based sleep study (privately insured patients)<\/div><\/label><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"checkbox\" value=\"Home based sleep study\" \/><div>Home-based sleep study * (Bulk Billed)<\/div><\/label><\/div><input class=\"super-shortcode-field\" type=\"hidden\" name=\"field_XPcrS\" value=\"\" data-oname=\"field_XPcrS\" data-email=\"Sleep Study * (Bulk Billed)\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"color:#ff0000; font-size:10px;\">* Please complete the ESS and STOP-Bang questionnaires. For a direct referral based on screening scores, Medicare requires ESS \u2265 8 and either STOP-Bang \u2265 3, OSA-50 \u2265 5 or a high-risk Berlin score.<br \/>\n<\/span><\/div><textarea><span style=\"color:#ff0000; font-size:10px;\">* Please complete the ESS and STOP-Bang questionnaires. For a direct referral based on screening scores, Medicare requires ESS \u2265 8 and either STOP-Bang \u2265 3, OSA-50 \u2265 5 or a high-risk Berlin score.<br \/>\n<\/span><\/textarea><textarea class=\"super-shortcode-field super-hidden\" name=\"field_fLExe\" data-oname=\"field_fLExe\" data-exclude=\"2\" data-exclude-entry=\"true\" data-absolute-default=\"\" ><span style=\"color:#ff0000; font-size:10px;\">* Please complete the ESS and STOP-Bang questionnaires. For a direct referral based on screening scores, Medicare requires ESS \u2265 8 and either STOP-Bang \u2265 3, OSA-50 \u2265 5 or a high-risk Berlin score.<br \/>\n<\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_half super-column grid-level-1 column-number-2\"><div class=\"super-shortcode super-field super-checkbox super-has-only-label   super-ungrouped   display-vertical\"><div class=\"super-label super-bottom-margin\">Respiratory Function Tests <\/div><div class=\"super-field-wrapper\"><div class=\"super-items-list\"><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"checkbox\" value=\"Spirometry &amp; Transfer Factor\" \/><div>Spirometry &#038; Transfer Factor<\/div><\/label><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"checkbox\" value=\"FeNO &amp; Spirometry\" \/><div>FeNO &#038; Spirometry<\/div><\/label><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"checkbox\" value=\"Plethysmographic Lung Volumes\" \/><div>Plethysmographic Lung Volumes<\/div><\/label><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"checkbox\" value=\"Bronchial Provocation Test\" \/><div>Bronchial Provocation Test<\/div><\/label><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"checkbox\" value=\"Maximal Respiratory Pressures\" \/><div>Maximal Respiratory Pressures<\/div><\/label><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"checkbox\" value=\"6 minute walk test\" \/><div>6-minute walk test<\/div><\/label><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"checkbox\" value=\"Ambulatory Oxygen Assessment\" \/><div>Ambulatory Oxygen Assessment<\/div><\/label><\/div><input class=\"super-shortcode-field\" type=\"hidden\" name=\"field_XTinn\" value=\"\" data-oname=\"field_XTinn\" data-email=\"Respiratory Function Tests:\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><\/div><\/div><\/div><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_half super-column grid-level-0 column-number-1 first-column\"><div class=\"super-shortcode super-field super-dropdown super-has-only-label  super-filled  super-ungrouped\"><div class=\"super-label super-bottom-margin\">Preferred clinic<\/div><div class=\"super-field-wrapper\"><input type=\"hidden\" class=\"super-shortcode-field\" name=\"preferred_clinic\" value=\"No preference\" data-oname=\"preferred_clinic\" data-email=\"Preferred clinic:\" data-exclude=\"0\" data-absolute-default=\"No preference\" data-default-value=\"No preference\" placeholder=\"- select a clinic -\" \/><input tabindex=\"-1\" type=\"text\" name=\"super-dropdown-search\" value=\"\" data-logic=\"contains\" \/><ul class=\"super-dropdown-list\"><li data-value=\"\" class=\"super-item super-placeholder\">No preference \u2013 closest to the patient<\/li><li class=\"super-item super-default-selected super-active\" data-value=\"No preference\" data-search-value=\"No preference \u2013 closest to the patient\"><div>No preference \u2013 closest to the patient<\/div><\/li><li class=\"super-item\" data-value=\"Epping\" data-search-value=\"Epping\"><div>Epping<\/div><\/li><li class=\"super-item\" data-value=\"Brunswick\" data-search-value=\"Brunswick\"><div>Brunswick<\/div><\/li><li class=\"super-item\" data-value=\"Doncaster East\" data-search-value=\"Doncaster East\"><div>Doncaster East<\/div><\/li><li class=\"super-item\" data-value=\"Braybrook\" data-search-value=\"Braybrook\"><div>Braybrook<\/div><\/li><li class=\"super-item\" data-value=\"Kilmore\" data-search-value=\"Kilmore\"><div>Kilmore<\/div><\/li><\/ul><span class=\"super-dropdown-arrow\"><span class=\"super-after\"><i class=\"fas fa-caret-down\"><\/i><\/span><\/span><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><div class=\"salc-prep salc-prep-gp\"><h3>Withholding times for lung function tests<\/h3><p>If you are ordering lung function tests, please give the patient these withholding times &mdash; a long-acting inhaler taken that morning may invalidate the pre-bronchodilator result, and the test may have to be repeated. Patients should not stop a medicine they need to stay safe. <a href=\"https:\/\/sleepandlungcare.com.au\/respiratory-function-tests\/#preparing\" target=\"_blank\" rel=\"noopener\">Printable patient version &rarr;<\/a><\/p><div class=\"salc-tablewrap\"><table class=\"salc-table\"><thead><tr><th>Medicine (examples)<\/th><th>Spirometry, lung volumes, gas transfer, FeNO<\/th><th>Bronchial provocation (mannitol)<\/th><\/tr><\/thead><tbody><tr><td>Reliever puffers \u2014 salbutamol (Ventolin, Asmol, Airomir), terbutaline (Bricanyl)<\/td><td>4\u20136 hours<\/td><td>8 hours<\/td><\/tr><tr><td>Ipratropium (Atrovent)<\/td><td>12 hours<\/td><td>12 hours<\/td><\/tr><tr><td>Twice-daily long-acting and combination inhalers \u2014 Seretide, Symbicort, Flutiform, DuoResp, Fostair, Serevent, Oxis<\/td><td>24 hours<\/td><td>36 hours<\/td><\/tr><tr><td>Once-daily long-acting inhalers \u2014 Breo Ellipta, Trelegy, Anoro, Ultibro, Spiolto, Onbrez, Striverdi<\/td><td>36\u201348 hours<\/td><td>72 hours<\/td><\/tr><tr><td>Twice-daily triple-therapy inhalers (they contain a long-acting anticholinergic) \u2014 Trimbow, Breztri<\/td><td>36\u201348 hours<\/td><td>72 hours<\/td><\/tr><tr><td>Long-acting anticholinergics \u2014 Spiriva, Seebri, Incruse, Bretaris<\/td><td>36\u201348 hours<\/td><td>72 hours<\/td><\/tr><tr><td>Preventer-only inhaled steroid \u2014 Flixotide, Pulmicort, Qvar, Alvesco<\/td><td>Take as usual<\/td><td>Skip the morning dose (6 hours)<\/td><\/tr><tr><td>Montelukast (Singulair)<\/td><td>Take as usual<\/td><td>4 days<\/td><\/tr><tr><td>Antihistamines \u2014 Zyrtec, Claratyne, Telfast, Phenergan<\/td><td>Take as usual<\/td><td>72 hours<\/td><\/tr><tr><td>Theophylline (Nuelin)<\/td><td>Take as usual<\/td><td>24 hours<\/td><\/tr><tr><td>Caffeine \u2014 coffee, tea, cola, energy drinks, chocolate<\/td><td>Avoid on the morning of the test<\/td><td>24 hours<\/td><\/tr><tr><td>Smoking or vaping<\/td><td>Not within 1 hour<\/td><td>Not within 1 hour<\/td><\/tr><tr><td>Alcohol<\/td><td>Not within 8 hours<\/td><td>Not within 8 hours<\/td><\/tr><tr><td>Vigorous exercise \u00b7 a large meal<\/td><td>Not within 1 hour \u00b7 not within 2 hours<\/td><td>Not within 1 hour \u00b7 not within 2 hours<\/td><\/tr><\/tbody><\/table><\/div><\/div><\/div><textarea><div class=\"salc-prep salc-prep-gp\"><h3>Withholding times for lung function tests<\/h3><p>If you are ordering lung function tests, please give the patient these withholding times &mdash; a long-acting inhaler taken that morning may invalidate the pre-bronchodilator result, and the test may have to be repeated. Patients should not stop a medicine they need to stay safe. <a href=\"https:\/\/sleepandlungcare.com.au\/respiratory-function-tests\/#preparing\" target=\"_blank\" rel=\"noopener\">Printable patient version &rarr;<\/a><\/p><div class=\"salc-tablewrap\"><table class=\"salc-table\"><thead><tr><th>Medicine (examples)<\/th><th>Spirometry, lung volumes, gas transfer, FeNO<\/th><th>Bronchial provocation (mannitol)<\/th><\/tr><\/thead><tbody><tr><td>Reliever puffers \u2014 salbutamol (Ventolin, Asmol, Airomir), terbutaline (Bricanyl)<\/td><td>4\u20136 hours<\/td><td>8 hours<\/td><\/tr><tr><td>Ipratropium (Atrovent)<\/td><td>12 hours<\/td><td>12 hours<\/td><\/tr><tr><td>Twice-daily long-acting and combination inhalers \u2014 Seretide, Symbicort, Flutiform, DuoResp, Fostair, Serevent, Oxis<\/td><td>24 hours<\/td><td>36 hours<\/td><\/tr><tr><td>Once-daily long-acting inhalers \u2014 Breo Ellipta, Trelegy, Anoro, Ultibro, Spiolto, Onbrez, Striverdi<\/td><td>36\u201348 hours<\/td><td>72 hours<\/td><\/tr><tr><td>Twice-daily triple-therapy inhalers (they contain a long-acting anticholinergic) \u2014 Trimbow, Breztri<\/td><td>36\u201348 hours<\/td><td>72 hours<\/td><\/tr><tr><td>Long-acting anticholinergics \u2014 Spiriva, Seebri, Incruse, Bretaris<\/td><td>36\u201348 hours<\/td><td>72 hours<\/td><\/tr><tr><td>Preventer-only inhaled steroid \u2014 Flixotide, Pulmicort, Qvar, Alvesco<\/td><td>Take as usual<\/td><td>Skip the morning dose (6 hours)<\/td><\/tr><tr><td>Montelukast (Singulair)<\/td><td>Take as usual<\/td><td>4 days<\/td><\/tr><tr><td>Antihistamines \u2014 Zyrtec, Claratyne, Telfast, Phenergan<\/td><td>Take as usual<\/td><td>72 hours<\/td><\/tr><tr><td>Theophylline (Nuelin)<\/td><td>Take as usual<\/td><td>24 hours<\/td><\/tr><tr><td>Caffeine \u2014 coffee, tea, cola, energy drinks, chocolate<\/td><td>Avoid on the morning of the test<\/td><td>24 hours<\/td><\/tr><tr><td>Smoking or vaping<\/td><td>Not within 1 hour<\/td><td>Not within 1 hour<\/td><\/tr><tr><td>Alcohol<\/td><td>Not within 8 hours<\/td><td>Not within 8 hours<\/td><\/tr><tr><td>Vigorous exercise \u00b7 a large meal<\/td><td>Not within 1 hour \u00b7 not within 2 hours<\/td><td>Not within 1 hour \u00b7 not within 2 hours<\/td><\/tr><\/tbody><\/table><\/div><\/div><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_full super-column grid-level-0 column-number-1 first-column\"><div class=\"super-shortcode super-field super-textarea   super-ungrouped\"><div class=\"super-field-wrapper\"><textarea tabindex=\"-1\" class=\"super-shortcode-field\" name=\"question\" data-oname=\"question\" data-email=\"Clinical Notes:\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" placeholder=\"Clinical Notes\" ><\/textarea><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><div class=\"super-shortcode super-field super-file super-has-label-desc   super-ungrouped\"><div class=\"super-label\">Attach the referral letter (optional)<\/div><div class=\"super-description\">A PDF, or a photo of each page (JPG, PNG or HEIC). Up to 3 files, 10 MB each. If you attach nothing, this form itself is filed as the referral.<\/div><div class=\"super-field-wrapper\"><div class=\"super-fileupload-button\"><i class=\"fas fa-plus\"><\/i><span class=\"super-fileupload-button-text\">Choose file(s)<\/span><\/div><input tabindex=\"-1\" class=\"super-shortcode-field super-fileupload\" type=\"file\" name=\"files[]\"  data-file-size=\"10\" data-upload-limit=\"30\" data-accept-file-types=\"pdf|jpg|jpeg|png|heic|heif|PDF|JPG|JPEG|PNG|HEIC|HEIF\" multiple \/><input class=\"super-active-files\" type=\"hidden\" value=\"\" name=\"referral_letter\" data-oname=\"referral_letter\" data-message=\"Please attach a PDF, JPG, PNG or HEIC file of 10 MB or less.\" data-email=\"Referral letter:\" data-exclude=\"1\" data-absolute-default=\"\" data-maxfiles=\"3\" \/><div class=\"super-progress-bar\"><\/div><div class=\"super-fileupload-files\"><\/div><\/div><div class=\"super-error-msg\">Please attach a PDF, JPG, PNG or HEIC file of 10 MB or less.<\/div><div class=\"super-empty-error-msg\">Please attach a PDF, JPG, PNG or HEIC file of 10 MB or less.<\/div><\/div><div class=\"super-shortcode super-field super-heading   super-ungrouped\"><div class=\"super-heading-title\"><h3>Requesting Doctor <\/h3><\/div><\/div><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_half super-column grid-level-1 column-number-1 first-column\"><div class=\"super-shortcode super-field super-text   super-ungrouped\"><div class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"doctor_first\" data-oname=\"doctor_first\" data-message=\"Please enter your first name.\" data-validation=\"empty\" data-email=\"Doctor first name:\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" placeholder=\"Doctor first name*\" \/><\/div><div class=\"super-error-msg\">Please enter your first name.<\/div><div class=\"super-empty-error-msg\">Please enter your first name.<\/div><\/div><div class=\"super-shortcode super-field super-text   super-ungrouped\"><div class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"doctor_surname\" data-oname=\"doctor_surname\" data-message=\"Please enter your surname.\" data-validation=\"empty\" data-email=\"Doctor surname:\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" placeholder=\"Doctor surname*\" \/><\/div><div class=\"super-error-msg\">Please enter your surname.<\/div><div class=\"super-empty-error-msg\">Please enter your surname.<\/div><\/div><div class=\"super-shortcode super-field super-text   super-ungrouped\"><div class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"field_XgkVh\" data-oname=\"field_XgkVh\" data-validation=\"empty\" data-email=\"Address\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" placeholder=\"Address*\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><div class=\"super-shortcode super-field super-text   super-ungrouped\"><div class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"field_egsAK\" data-oname=\"field_egsAK\" data-email=\"Copy report to:\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" placeholder=\"Copy report to (other doctors)\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><div class=\"super-shortcode super-field super-text   super-ungrouped\"><div class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"phonenumber_1\" data-oname=\"phonenumber_1\" data-validation=\"phone\" data-email=\"Phone\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" placeholder=\"Phone*\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_half super-column grid-level-1 column-number-2\"><div class=\"super-shortcode super-field super-text   super-ungrouped\"><div class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"name\" data-oname=\"name\" data-validation=\"empty\" data-email=\"Provider number\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" placeholder=\"Provider number*\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><div class=\"super-shortcode super-field super-text   super-ungrouped\"><div class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"email\" data-oname=\"email\" data-message=\"Please enter the practice email address.\" data-validation=\"email\" data-email=\"Practice email:\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" placeholder=\"Practice email* (we confirm receipt here)\" \/><\/div><div class=\"super-error-msg\">Please enter the practice email address.<\/div><div class=\"super-empty-error-msg\">Please enter the practice email address.<\/div><\/div><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><div class=\"salc-sig\" data-salc-sig><p class=\"salc-sig-noscript\">Signature: please enable JavaScript to sign on screen.<\/p><\/div><\/div><textarea><div class=\"salc-sig\" data-salc-sig><p class=\"salc-sig-noscript\">Signature: please enable JavaScript to sign on screen.<\/p><\/div><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><div class=\"super-shortcode super-field super-hidden   super-ungrouped   hidden\"><input class=\"super-shortcode-field\" type=\"hidden\" name=\"salc_sig_img\" data-oname=\"salc_sig_img\" value=\"\" data-default-value=\"\" data-absolute-default=\"\" data-email=\"Signature image:\" data-exclude=\"2\" \/><\/div><div class=\"super-shortcode super-field super-hidden   super-ungrouped   hidden\"><input class=\"super-shortcode-field\" type=\"hidden\" name=\"salc_sig_method\" data-oname=\"salc_sig_method\" value=\"\" data-default-value=\"\" data-absolute-default=\"\" data-email=\"Signature:\" \/><\/div><div class=\"super-shortcode super-field super-text   super-ungrouped\"><div class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"name_1\" data-oname=\"name_1\" data-email=\"Fax\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" placeholder=\"Fax\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><\/div><\/div><\/div><div class=\"super-shortcode super-field super-heading   super-ungrouped\"><div class=\"super-heading-title\"><h3>EPWORTH SLEEPINESS SCALE (ESS)<\/h3><\/div><\/div><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_half super-column grid-level-0 column-number-1 first-column\"><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\">Use the 0\u20133 scale to choose the most appropriate number for each situation<\/div><textarea>Use the 0\u20133 scale to choose the most appropriate number for each situation<\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_half super-column grid-level-0 column-number-2\"><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\">0 = would never doze<br \/>\n1 = slight chance of dozing<br \/>\n2 = moderate chance of dozing<br \/>\n3 = high chance of dozing<br \/>\n<\/div><textarea>0 = would never doze<br \/>\n1 = slight chance of dozing<br \/>\n2 = moderate chance of dozing<br \/>\n3 = high chance of dozing<br \/>\n<\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><\/div><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_full super-column grid-level-0 column-number-1 first-column\"><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_half super-column grid-level-1 column-number-1 first-column\"><div class=\"super-shortcode super-field super-heading   super-ungrouped\"><div class=\"super-heading-title\"><h3>SITUATION <\/h3><\/div><\/div><\/div><div class=\"super-shortcode super_one_half super-column grid-level-1 column-number-2\"><div class=\"super-shortcode super-field super-heading   super-ungrouped\"><div class=\"super-heading-title\"><h3>CHANCE OF DOZING (0 &#8211; 3)<\/h3><\/div><\/div><\/div><\/div><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_full super-column grid-level-1 column-number-1 first-column\"><div style=\"padding-top:20px;padding-bottom:20px;\" class=\"super-shortcode super-field super-divider  super-align-left  super-ungrouped   align-left border-single style-dashed back-0\"><div class=\"super-divider-inner\" style=\"width:100%;border-color:#444444;border-top-width:1px;border-bottom-width:1px;height:1px;\"><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-1 first-column\"><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\"> Sitting and reading<\/span><\/div><textarea><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\"> Sitting and reading<\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-2\"><div class=\"super-shortcode super-field super-quantity   super-ungrouped\"><div class=\"super-quantity-field-wrap\"><span class=\"super-minus-button super-noselect\"><i>&#8211;<\/i><\/span><div style=\"width:50px;\" class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"Sitting_and_reading\" value=\"0\" data-steps=\"1\" data-oname=\"Sitting_and_reading\" data-email=\"Sitting and reading:\" data-exclude=\"0\" data-absolute-default=\"0\" data-default-value=\"0\" data-minnumber=\"0\" data-maxnumber=\"3\" \/><\/div><span class=\"super-plus-button super-noselect\"><i>+<\/i><\/span><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-3\"><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\"> Watching TV<br \/>\n<\/span><\/div><textarea><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\"> Watching TV<br \/>\n<\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-4\"><div class=\"super-shortcode super-field super-quantity   super-ungrouped\"><div class=\"super-quantity-field-wrap\"><span class=\"super-minus-button super-noselect\"><i>&#8211;<\/i><\/span><div style=\"width:50px;\" class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"Watching_TV\" value=\"0\" data-steps=\"1\" data-oname=\"Watching_TV\" data-email=\"Watching TV:\" data-exclude=\"0\" data-absolute-default=\"0\" data-default-value=\"0\" data-minnumber=\"0\" data-maxnumber=\"3\" \/><\/div><span class=\"super-plus-button super-noselect\"><i>+<\/i><\/span><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><\/div><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-1 first-column\"><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\"> Sitting, inactive in a public place (e.g. a theatre or a meeting)<br \/>\n<\/span><\/div><textarea><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\"> Sitting, inactive in a public place (e.g. a theatre or a meeting)<br \/>\n<\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-2\"><div class=\"super-shortcode super-field super-quantity   super-ungrouped\"><div class=\"super-quantity-field-wrap\"><span class=\"super-minus-button super-noselect\"><i>&#8211;<\/i><\/span><div style=\"width:50px;\" class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"field_rKhTn\" value=\"0\" data-steps=\"1\" data-oname=\"field_rKhTn\" data-email=\"Sitting, inactive in a public place (e.g. a theatre or a meeting):\" data-exclude=\"0\" data-absolute-default=\"0\" data-default-value=\"0\" data-minnumber=\"0\" data-maxnumber=\"3\" \/><\/div><span class=\"super-plus-button super-noselect\"><i>+<\/i><\/span><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-3\"><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\"> As a passenger in a car for an hour without a break<\/span><\/div><textarea><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\"> As a passenger in a car for an hour without a break<\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-4\"><div class=\"super-shortcode super-field super-quantity   super-ungrouped\"><div class=\"super-quantity-field-wrap\"><span class=\"super-minus-button super-noselect\"><i>&#8211;<\/i><\/span><div style=\"width:50px;\" class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"field_OQuAp\" value=\"0\" data-steps=\"1\" data-oname=\"field_OQuAp\" data-email=\"As a passenger in a car for an hour without a break:\" data-exclude=\"0\" data-absolute-default=\"0\" data-default-value=\"0\" data-minnumber=\"0\" data-maxnumber=\"3\" \/><\/div><span class=\"super-plus-button super-noselect\"><i>+<\/i><\/span><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><\/div><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-1 first-column\"><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\"> Lying down to rest in the afternoon when circumstances permit<\/span><\/div><textarea><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\"> Lying down to rest in the afternoon when circumstances permit<\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-2\"><div class=\"super-shortcode super-field super-quantity   super-ungrouped\"><div class=\"super-quantity-field-wrap\"><span class=\"super-minus-button super-noselect\"><i>&#8211;<\/i><\/span><div style=\"width:50px;\" class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"field_zzzMP\" value=\"0\" data-steps=\"1\" data-oname=\"field_zzzMP\" data-email=\"Lying down to rest in the afternoon when circumstances permit:\" data-exclude=\"0\" data-absolute-default=\"0\" data-default-value=\"0\" data-minnumber=\"0\" data-maxnumber=\"3\" \/><\/div><span class=\"super-plus-button super-noselect\"><i>+<\/i><\/span><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-3\"><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\"> Sitting and talking to someone<\/span><\/div><textarea><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\"> Sitting and talking to someone<\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-4\"><div class=\"super-shortcode super-field super-quantity   super-ungrouped\"><div class=\"super-quantity-field-wrap\"><span class=\"super-minus-button super-noselect\"><i>&#8211;<\/i><\/span><div style=\"width:50px;\" class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"field_LolCd\" value=\"0\" data-steps=\"1\" data-oname=\"field_LolCd\" data-email=\"Sitting and talking to someone:\" data-exclude=\"0\" data-absolute-default=\"0\" data-default-value=\"0\" data-minnumber=\"0\" data-maxnumber=\"3\" \/><\/div><span class=\"super-plus-button super-noselect\"><i>+<\/i><\/span><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><\/div><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-1 first-column\"><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\"> Sitting quietly after a lunch without alcohol<\/span><\/div><textarea><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\"> Sitting quietly after a lunch without alcohol<\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-2\"><div class=\"super-shortcode super-field super-quantity   super-ungrouped\"><div class=\"super-quantity-field-wrap\"><span class=\"super-minus-button super-noselect\"><i>&#8211;<\/i><\/span><div style=\"width:50px;\" class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"field_Qahty\" value=\"0\" data-steps=\"1\" data-oname=\"field_Qahty\" data-email=\"Sitting quietly after a lunch without alcohol:\" data-exclude=\"0\" data-absolute-default=\"0\" data-default-value=\"0\" data-minnumber=\"0\" data-maxnumber=\"3\" \/><\/div><span class=\"super-plus-button super-noselect\"><i>+<\/i><\/span><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-3\"><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\"> In a car, while stopped for a few minutes in the traffic<\/span><\/div><textarea><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\"> In a car, while stopped for a few minutes in the traffic<\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-4\"><div class=\"super-shortcode super-field super-quantity   super-ungrouped\"><div class=\"super-quantity-field-wrap\"><span class=\"super-minus-button super-noselect\"><i>&#8211;<\/i><\/span><div style=\"width:50px;\" class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"field_uGjHK\" value=\"0\" data-steps=\"1\" data-oname=\"field_uGjHK\" data-email=\"In a car, while stopped for a few minutes in the traffic:\" data-exclude=\"0\" data-absolute-default=\"0\" data-default-value=\"0\" data-minnumber=\"0\" data-maxnumber=\"3\" \/><\/div><span class=\"super-plus-button super-noselect\"><i>+<\/i><\/span><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><\/div><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_half super-column grid-level-0 column-number-1 first-column\"><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"font-size: 20px; font-family: \"open sans\",sans-serif; color:#000000;\"> Write down total score<\/span><\/div><textarea><span style=\"font-size: 20px; font-family: \"open sans\",sans-serif; color:#000000;\"> Write down total score<\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"color:#ff0000; font-size:10px;\">For a direct referral based on screening scores, the ESS score needs to be \u2265 8.<\/span><\/div><textarea><span style=\"color:#ff0000; font-size:10px;\">For a direct referral based on screening scores, the ESS score needs to be \u2265 8.<\/span><\/textarea><textarea class=\"super-shortcode-field super-hidden\" name=\"filed_ZZmmp\" data-oname=\"filed_ZZmmp\" data-email=\"HTML:\" data-exclude=\"2\" data-exclude-entry=\"true\" data-absolute-default=\"\" ><span style=\"color:#ff0000; font-size:10px;\">For a direct referral based on screening scores, the ESS score needs to be \u2265 8.<\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_half super-column grid-level-0 column-number-2\"><div class=\"super-shortcode super-field super-text   super-ungrouped\"><div class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"name_3\" data-oname=\"name_3\" data-email=\"Total Score:\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><\/div><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_full super-column grid-level-0 column-number-1 first-column\"><div style=\"padding-top:20px;padding-bottom:20px;\" class=\"super-shortcode super-field super-divider  super-align-left  super-ungrouped   align-left border-single style-dashed back-0\"><div class=\"super-divider-inner\" style=\"width:100%;border-color:#444444;border-top-width:1px;border-bottom-width:1px;height:1px;\"><\/div><\/div><div class=\"super-shortcode super-field super-heading   super-ungrouped\"><div class=\"super-heading-title\"><h3>STOP-Bang QUESTIONNAIRE<\/h3><\/div><\/div><\/div><\/div><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-1 first-column\"><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\">Do you SNORE loudly? <\/span><\/div><textarea><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\">Do you SNORE loudly? <\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-2\"><div class=\"super-shortcode super-field super-radio   super-ungrouped   display-vertical\"><div class=\"super-field-wrapper\"><div class=\"super-items-list\"><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"radio\" value=\"yes\" \/><div>Yes<\/div><\/label><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"radio\" value=\"no\" \/><div>No<\/div><\/label><\/div><input class=\"super-shortcode-field\" type=\"hidden\" name=\"option_1\" value=\"\" data-oname=\"option_1\" data-email=\"Do you SNORE loudly? :\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-3\"><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\">Do you often feel TIRED, fatigued, or sleepy during the daytime? <\/span><\/div><textarea><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\">Do you often feel TIRED, fatigued, or sleepy during the daytime? <\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-4\"><div class=\"super-shortcode super-field super-radio   super-ungrouped   display-vertical\"><div class=\"super-field-wrapper\"><div class=\"super-items-list\"><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"radio\" value=\"yes\" \/><div>Yes<\/div><\/label><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"radio\" value=\"no\" \/><div>No<\/div><\/label><\/div><input class=\"super-shortcode-field\" type=\"hidden\" name=\"field_zoCZo\" value=\"\" data-oname=\"field_zoCZo\" data-email=\"Do you often feel TIRED, fatigued, or sleepy during the daytime? :\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><\/div><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-1 first-column\"><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\">Has anyone OBSERVED you stop breathing or choke or gasp for air during your sleep? <\/span><\/div><textarea><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\">Has anyone OBSERVED you stop breathing or choke or gasp for air during your sleep? <\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-2\"><div class=\"super-shortcode super-field super-radio   super-ungrouped   display-vertical\"><div class=\"super-field-wrapper\"><div class=\"super-items-list\"><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"radio\" value=\"yes\" \/><div>Yes<\/div><\/label><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"radio\" value=\"no\" \/><div>No<\/div><\/label><\/div><input class=\"super-shortcode-field\" type=\"hidden\" name=\"field_JVBZY\" value=\"\" data-oname=\"field_JVBZY\" data-email=\"Has anyone OBSERVED you stop breathing or choke or gasp for air during your sleep? :\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-3\"><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\">Do you have or are you being treated for high blood PRESSURE? <\/span><\/div><textarea><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\">Do you have or are you being treated for high blood PRESSURE? <\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-4\"><div class=\"super-shortcode super-field super-radio   super-ungrouped   display-vertical\"><div class=\"super-field-wrapper\"><div class=\"super-items-list\"><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"radio\" value=\"yes\" \/><div>Yes<\/div><\/label><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"radio\" value=\"no\" \/><div>No<\/div><\/label><\/div><input class=\"super-shortcode-field\" type=\"hidden\" name=\"field_BSxyC\" value=\"\" data-oname=\"field_BSxyC\" data-email=\"Do you have or are you being treated for high blood PRESSURE? :\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><\/div><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-1 first-column\"><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\">BMI more than 35 kg\/m\u00b2?<\/span><\/div><textarea><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\">BMI more than 35 kg\/m\u00b2?<\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-2\"><div class=\"super-shortcode super-field super-radio   super-ungrouped   display-vertical\"><div class=\"super-field-wrapper\"><div class=\"super-items-list\"><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"radio\" value=\"yes\" \/><div>Yes<\/div><\/label><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"radio\" value=\"no\" \/><div>No<\/div><\/label><\/div><input class=\"super-shortcode-field\" type=\"hidden\" name=\"field_gPHGo\" value=\"\" data-oname=\"field_gPHGo\" data-email=\"BMI more than 35 kg per m2 ? :\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-3\"><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\">Age over 50 years old? <\/span><\/div><textarea><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\">Age over 50 years old? <\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-4\"><div class=\"super-shortcode super-field super-radio   super-ungrouped   display-vertical\"><div class=\"super-field-wrapper\"><div class=\"super-items-list\"><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"radio\" value=\"yes\" \/><div>Yes<\/div><\/label><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"radio\" value=\"no\" \/><div>No<\/div><\/label><\/div><input class=\"super-shortcode-field\" type=\"hidden\" name=\"field_KVqOJ\" value=\"\" data-oname=\"field_KVqOJ\" data-email=\"Age over 50 years old? :\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><\/div><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-1 first-column\"><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\">Neck circumference 43 cm or more (men) \/ 41 cm or more (women)?<\/span><\/div><textarea><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\">Neck circumference 43 cm or more (men) \/ 41 cm or more (women)?<\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-2\"><div class=\"super-shortcode super-field super-radio   super-ungrouped   display-vertical\"><div class=\"super-field-wrapper\"><div class=\"super-items-list\"><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"radio\" value=\"yes\" \/><div>Yes<\/div><\/label><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"radio\" value=\"no\" \/><div>No<\/div><\/label><\/div><input class=\"super-shortcode-field\" type=\"hidden\" name=\"field_RsOpz\" value=\"\" data-oname=\"field_RsOpz\" data-email=\"Neck circumference 43 cm or more (men) \/ 41 cm or more (women)?:\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-3\"><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\">Gender: Male?<\/span><\/div><textarea><span style=\"font-size: 14px; font-family: \"open sans\",sans-serif; color:#000000;\">Gender: Male?<\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_fourth super-column grid-level-0 column-number-4\"><div class=\"super-shortcode super-field super-radio   super-ungrouped   display-vertical\"><div class=\"super-field-wrapper\"><div class=\"super-items-list\"><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"radio\" value=\"yes\" \/><div>Yes<\/div><\/label><label class=\"super-item\" ><span class=\"super-before\"><span class=\"super-after\"><\/span><\/span><input type=\"radio\" value=\"no\" \/><div>No<\/div><\/label><\/div><input class=\"super-shortcode-field\" type=\"hidden\" name=\"field_JMOsX\" value=\"\" data-oname=\"field_JMOsX\" data-email=\"Gender: Male?:\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><\/div><div class=\"super-grid super-shortcode\"><div class=\"super-shortcode super_one_half super-column grid-level-0 column-number-1 first-column\"><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"font-size: 20px; font-family: \"open sans\",sans-serif; color:#000000;\"> Write down total YES score<\/span><\/div><textarea><span style=\"font-size: 20px; font-family: \"open sans\",sans-serif; color:#000000;\"> Write down total YES score<\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><div class=\"super-shortcode super-field super-html   super-ungrouped\"><div class=\"super-html-content\"><span style=\"color:#ff0000; font-size:10px;\">For the STOP-Bang direct-referral pathway, the STOP-Bang score needs to be \u2265 3 and the ESS score needs to be \u2265 8.<br \/>\n<\/span><\/div><textarea><span style=\"color:#ff0000; font-size:10px;\">For the STOP-Bang direct-referral pathway, the STOP-Bang score needs to be \u2265 3 and the ESS score needs to be \u2265 8.<br \/>\n<\/span><\/textarea><textarea class=\"super-shortcode-field super-hidden\" name=\"field_nZVPY\" data-oname=\"field_nZVPY\" data-exclude=\"2\" data-exclude-entry=\"true\" data-absolute-default=\"\" ><span style=\"color:#ff0000; font-size:10px;\">For the STOP-Bang direct-referral pathway, the STOP-Bang score needs to be \u2265 3 and the ESS score needs to be \u2265 8.<br \/>\n<\/span><\/textarea><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><div class=\"super-shortcode super_one_half super-column grid-level-0 column-number-2\"><div class=\"super-shortcode super-field super-text   super-ungrouped\"><div class=\"super-field-wrapper\"><input tabindex=\"-1\" class=\"super-shortcode-field\" type=\"text\" name=\"field_EPbdX\" data-oname=\"field_EPbdX\" data-email=\"Total Yes Score:\" data-exclude=\"0\" data-absolute-default=\"\" data-default-value=\"\" \/><\/div><div class=\"super-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><div class=\"super-empty-error-msg\">L\u0129nh v\u1ef1c \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u!<\/div><\/div><\/div><\/div><div data-color=\"#f20800\" data-light=\"#ff1c14\" data-dark=\"#d40000\" data-hover-color=\"#444444\" data-hover-light=\"#585858\" data-hover-dark=\"#262626\" data-font=\"#ffffff\" data-font-hover=\"#ffffff\" data-radius=\"square\" data-type=\"flat\" class=\"super-extra-shortcode super-shortcode super-field super-button super-clear-none super-form-button super-radius-square super-type-flat super-button-large super-button-align-left super-button-width-auto\"><div data-href=\"\" class=\"super-button-wrap no_link\"><div class=\"super-button-name\" data-action=\"submit\" data-normal=\"Submit\" data-loading=\"Loading...\">Submit<\/div><span class=\"super-after\"><\/span><\/div><\/div><input type=\"hidden\" name=\"trp-form-language\" value=\"vi\"\/><\/form><\/div><\/div><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"<p>Online Referral for GPs Bulk billing is available for home sleep studies and respiratory function tests with a valid referral.<\/p>","protected":false},"author":11,"featured_media":9287,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"rs_blank_template":"","rs_page_bg_color":"","slide_template_v7":"","footnotes":""},"class_list":["post-2496","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Online Referral Form for GPs | Sleep and Lung Care<\/title>\n<meta name=\"description\" content=\"Refer a patient online for a consultation, lung function tests or an eligible bulk billed home sleep study. Includes the Epworth and STOP-Bang questionnaires Medicare requires.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/sleepandlungcare.com.au\/vi\/online-referrals\/\" \/>\n<meta property=\"og:locale\" content=\"vi_VN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Online Referral Form for GPs | Sleep and Lung Care\" \/>\n<meta property=\"og:description\" content=\"Refer a patient online for a consultation, lung function tests or an eligible bulk billed home sleep study. Includes the Epworth and STOP-Bang questionnaires Medicare requires.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/sleepandlungcare.com.au\/vi\/online-referrals\/\" \/>\n<meta property=\"og:site_name\" content=\"Sleep and Lung Care\" \/>\n<meta property=\"article:modified_time\" content=\"2026-10-17T03:54:47+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/sleepandlungcare.com.au\/wp-content\/uploads\/2023\/10\/iStock-695218436.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"1600\" \/>\n\t<meta property=\"og:image:height\" content=\"1067\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/webp\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/vi\\\/online-referrals\\\/\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/vi\\\/online-referrals\\\/\",\"name\":\"Online Referral Form for GPs | Sleep and Lung Care\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/vi\\\/online-referrals\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/vi\\\/online-referrals\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/wp-content\\\/uploads\\\/2023\\\/10\\\/iStock-695218436.webp\",\"datePublished\":\"2018-08-16T06:55:27+00:00\",\"dateModified\":\"2026-10-17T03:54:47+00:00\",\"description\":\"Refer a patient online for a consultation, lung function tests or an eligible bulk billed home sleep study. Includes the Epworth and STOP-Bang questionnaires Medicare requires.\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/vi\\\/online-referrals\\\/#breadcrumb\"},\"inLanguage\":\"vi\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/sleepandlungcare.com.au\\\/vi\\\/online-referrals\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"vi\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/vi\\\/online-referrals\\\/#primaryimage\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/wp-content\\\/uploads\\\/2023\\\/10\\\/iStock-695218436.webp\",\"contentUrl\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/wp-content\\\/uploads\\\/2023\\\/10\\\/iStock-695218436.webp\",\"width\":1600,\"height\":1067,\"caption\":\"For doctors: refer a patient to Sleep and Lung Care\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/vi\\\/online-referrals\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/vi\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Online Referral\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/#website\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/\",\"name\":\"Sleep and Lung Care\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-AU\"},{\"@type\":[\"MedicalOrganization\",\"Organization\"],\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/#organization\",\"name\":\"Sleep and Lung Care\",\"alternateName\":\"Sleep & Lung Care\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"vi\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/wp-content\\\/uploads\\\/2018\\\/06\\\/dmd-Sleep-_-Lung-Care-logo-2-e1539502583960.png\",\"contentUrl\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/wp-content\\\/uploads\\\/2018\\\/06\\\/dmd-Sleep-_-Lung-Care-logo-2-e1539502583960.png\",\"width\":250,\"height\":180,\"caption\":\"Sleep and Lung Care\"},\"image\":{\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.healthdirect.gov.au\\\/australian-health-services\\\/healthcare-service\\\/epping-3076-vic\\\/sleep-and-lung-care-epping\\\/pulmonary-medicine-service\\\/47509c58-ac5a-56d1-3c6b-367226c73fcf\",\"https:\\\/\\\/www.healthshare.com.au\\\/practices\\\/sleep-and-lung-care\\\/22852-epping-3076\\\/\",\"https:\\\/\\\/www.google.com\\\/maps?cid=14984205713445593390\",\"https:\\\/\\\/www.google.com\\\/maps?cid=7353079142284182143\",\"https:\\\/\\\/www.google.com\\\/maps?cid=18115290743171746048\",\"https:\\\/\\\/www.google.com\\\/maps?cid=18335186465836059051\",\"https:\\\/\\\/www.google.com\\\/maps?cid=12246870546291512960\"],\"description\":\"Sleep and Lung Care provides adult respiratory and sleep medicine consultations, lung function tests and sleep study services at clinics in Epping, Brunswick, Doncaster East, Braybrook and Kilmore, Victoria.\",\"telephone\":\"+61 3 9422 0077\",\"faxNumber\":\"+61 3 9454 9339\",\"email\":\"reception@sleepandlungcare.com.au\",\"medicalSpecialty\":[\"Pulmonary\",\"Sleep medicine\"],\"areaServed\":[\"Melbourne\",\"Victoria\"],\"isAcceptingNewPatients\":true,\"department\":[{\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/respiratory-sleep-physicians-epping\\\/#clinic\"},{\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/respiratory-sleep-physicians-brunswick\\\/#clinic\"},{\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/respiratory-sleep-physicians-doncaster-east\\\/#clinic\"},{\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/respiratory-sleep-physicians-braybrook\\\/#clinic\"},{\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/respiratory-sleep-physicians-kilmore\\\/#clinic\"}],\"physician\":[{\"@type\":\"Physician\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-irena-laska\\\/#physician\",\"name\":\"Dr Irena Laska\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-irena-laska\\\/\"},{\"@type\":\"Physician\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-maitri-munsif\\\/#physician\",\"name\":\"Dr Maitri Munsif\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-maitri-munsif\\\/\"},{\"@type\":\"Physician\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-jibin-thomas\\\/#physician\",\"name\":\"Dr Jibin Thomas\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-jibin-thomas\\\/\"},{\"@type\":\"Physician\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-daniel-niewodowski\\\/#physician\",\"name\":\"Dr Daniel Niewodowski\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-daniel-niewodowski\\\/\"},{\"@type\":\"Physician\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-benjamin-leaver\\\/#physician\",\"name\":\"Dr Benjamin Leaver\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-benjamin-leaver\\\/\"},{\"@type\":\"Physician\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-bassem-dawood\\\/#physician\",\"name\":\"Dr Bassem Dawood\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-bassem-dawood\\\/\"},{\"@type\":\"Physician\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-jayne-roberts\\\/#physician\",\"name\":\"Dr Jayne Roberts\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-jayne-roberts\\\/\"},{\"@type\":\"Physician\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-ashwin-rajan\\\/#physician\",\"name\":\"Dr Ashwin Rajan\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-ashwin-rajan\\\/\"},{\"@type\":\"Physician\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/mr-bibhusal-thapa\\\/#physician\",\"name\":\"Mr Bibhusal Thapa\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/mr-bibhusal-thapa\\\/\"},{\"@type\":\"Physician\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-cara-tanner\\\/#physician\",\"name\":\"Dr Cara Tanner\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-cara-tanner\\\/\"},{\"@type\":\"Physician\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-jessica-nash\\\/#physician\",\"name\":\"Dr Jessica Nash\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-jessica-nash\\\/\"},{\"@type\":\"Physician\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-raymond-wong\\\/#physician\",\"name\":\"Dr Raymond Wong\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-raymond-wong\\\/\"},{\"@type\":\"Physician\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-sanjeevan-muruganandan\\\/#physician\",\"name\":\"Associate Professor Sanjeevan Muruganandan\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-sanjeevan-muruganandan\\\/\"},{\"@type\":\"Physician\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-kanishka-rangamuwa\\\/#physician\",\"name\":\"Dr Kanishka Rangamuwa\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-kanishka-rangamuwa\\\/\"},{\"@type\":\"Physician\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-julien-robinson\\\/#physician\",\"name\":\"Dr Julien Robinson\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-julien-robinson\\\/\"},{\"@type\":\"Physician\",\"@id\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-jack-henderson\\\/#physician\",\"name\":\"Dr Jack Henderson\",\"url\":\"https:\\\/\\\/sleepandlungcare.com.au\\\/team-member\\\/dr-jack-henderson\\\/\"}]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Bi\u1ec3u m\u1eabu chuy\u1ec3n kh\u00e1m tr\u1ef1c tuy\u1ebfn d\u00e0nh cho b\u00e1c s\u0129 gia \u0111\u00ecnh | Sleep and Lung Care","description":"Chuy\u1ec3n kh\u00e1m cho b\u1ec7nh nh\u00e2n tr\u1ef1c tuy\u1ebfn \u0111\u1ec3 kh\u00e1m, x\u00e9t nghi\u1ec7m ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p ho\u1eb7c kh\u1ea3o s\u00e1t gi\u1ea5c ng\u1ee7 t\u1ea1i nh\u00e0 \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n \u0111\u01b0\u1ee3c Medicare thanh to\u00e1n to\u00e0n b\u1ed9 (bulk billed). Bao g\u1ed3m c\u00e1c b\u1ea3ng c\u00e2u h\u1ecfi Epworth v\u00e0 STOP-Bang m\u00e0 Medicare y\u00eau c\u1ea7u.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/sleepandlungcare.com.au\/vi\/online-referrals\/","og_locale":"vi_VN","og_type":"article","og_title":"Online Referral Form for GPs | Sleep and Lung Care","og_description":"Refer a patient online for a consultation, lung function tests or an eligible bulk billed home sleep study. Includes the Epworth and STOP-Bang questionnaires Medicare requires.","og_url":"https:\/\/sleepandlungcare.com.au\/vi\/online-referrals\/","og_site_name":"Sleep and Lung Care","article_modified_time":"2026-10-17T03:54:47+00:00","og_image":[{"width":1600,"height":1067,"url":"https:\/\/sleepandlungcare.com.au\/wp-content\/uploads\/2023\/10\/iStock-695218436.webp","type":"image\/webp"}],"twitter_card":"summary_large_image","schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/sleepandlungcare.com.au\/vi\/online-referrals\/","url":"https:\/\/sleepandlungcare.com.au\/vi\/online-referrals\/","name":"Bi\u1ec3u m\u1eabu chuy\u1ec3n kh\u00e1m tr\u1ef1c tuy\u1ebfn d\u00e0nh cho b\u00e1c s\u0129 gia \u0111\u00ecnh | Sleep and Lung Care","isPartOf":{"@id":"https:\/\/sleepandlungcare.com.au\/#website"},"primaryImageOfPage":{"@id":"https:\/\/sleepandlungcare.com.au\/vi\/online-referrals\/#primaryimage"},"image":{"@id":"https:\/\/sleepandlungcare.com.au\/vi\/online-referrals\/#primaryimage"},"thumbnailUrl":"https:\/\/sleepandlungcare.com.au\/wp-content\/uploads\/2023\/10\/iStock-695218436.webp","datePublished":"2018-08-16T06:55:27+00:00","dateModified":"2026-10-17T03:54:47+00:00","description":"Chuy\u1ec3n kh\u00e1m cho b\u1ec7nh nh\u00e2n tr\u1ef1c tuy\u1ebfn \u0111\u1ec3 kh\u00e1m, x\u00e9t nghi\u1ec7m ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p ho\u1eb7c kh\u1ea3o s\u00e1t gi\u1ea5c ng\u1ee7 t\u1ea1i nh\u00e0 \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n \u0111\u01b0\u1ee3c Medicare thanh to\u00e1n to\u00e0n b\u1ed9 (bulk billed). Bao g\u1ed3m c\u00e1c b\u1ea3ng c\u00e2u h\u1ecfi Epworth v\u00e0 STOP-Bang m\u00e0 Medicare y\u00eau c\u1ea7u.","breadcrumb":{"@id":"https:\/\/sleepandlungcare.com.au\/vi\/online-referrals\/#breadcrumb"},"inLanguage":"vi","potentialAction":[{"@type":"ReadAction","target":["https:\/\/sleepandlungcare.com.au\/vi\/online-referrals\/"]}]},{"@type":"ImageObject","inLanguage":"vi","@id":"https:\/\/sleepandlungcare.com.au\/vi\/online-referrals\/#primaryimage","url":"https:\/\/sleepandlungcare.com.au\/wp-content\/uploads\/2023\/10\/iStock-695218436.webp","contentUrl":"https:\/\/sleepandlungcare.com.au\/wp-content\/uploads\/2023\/10\/iStock-695218436.webp","width":1600,"height":1067,"caption":"For doctors: refer a patient to Sleep and Lung Care"},{"@type":"BreadcrumbList","@id":"https:\/\/sleepandlungcare.com.au\/vi\/online-referrals\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/sleepandlungcare.com.au\/vi\/"},{"@type":"ListItem","position":2,"name":"Online Referral"}]},{"@type":"WebSite","@id":"https:\/\/sleepandlungcare.com.au\/#website","url":"https:\/\/sleepandlungcare.com.au\/","name":"Sleep and Lung Care","description":"","publisher":{"@id":"https:\/\/sleepandlungcare.com.au\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/sleepandlungcare.com.au\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-AU"},{"@type":["MedicalOrganization","Organization"],"@id":"https:\/\/sleepandlungcare.com.au\/#organization","name":"Sleep and Lung Care","alternateName":"Sleep & Lung Care","url":"https:\/\/sleepandlungcare.com.au\/","logo":{"@type":"ImageObject","inLanguage":"vi","@id":"https:\/\/sleepandlungcare.com.au\/#\/schema\/logo\/image\/","url":"https:\/\/sleepandlungcare.com.au\/wp-content\/uploads\/2018\/06\/dmd-Sleep-_-Lung-Care-logo-2-e1539502583960.png","contentUrl":"https:\/\/sleepandlungcare.com.au\/wp-content\/uploads\/2018\/06\/dmd-Sleep-_-Lung-Care-logo-2-e1539502583960.png","width":250,"height":180,"caption":"Sleep and Lung Care"},"image":{"@id":"https:\/\/sleepandlungcare.com.au\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.healthdirect.gov.au\/australian-health-services\/healthcare-service\/epping-3076-vic\/sleep-and-lung-care-epping\/pulmonary-medicine-service\/47509c58-ac5a-56d1-3c6b-367226c73fcf","https:\/\/www.healthshare.com.au\/practices\/sleep-and-lung-care\/22852-epping-3076\/","https:\/\/www.google.com\/maps?cid=14984205713445593390","https:\/\/www.google.com\/maps?cid=7353079142284182143","https:\/\/www.google.com\/maps?cid=18115290743171746048","https:\/\/www.google.com\/maps?cid=18335186465836059051","https:\/\/www.google.com\/maps?cid=12246870546291512960"],"description":"Sleep and Lung Care provides adult respiratory and sleep medicine consultations, lung function tests and sleep study services at clinics in Epping, Brunswick, Doncaster East, Braybrook and Kilmore, Victoria.","telephone":"+61 3 9422 0077","faxNumber":"+61 3 9454 9339","email":"reception@sleepandlungcare.com.au","medicalSpecialty":["Pulmonary","Sleep medicine"],"areaServed":["Melbourne","Victoria"],"isAcceptingNewPatients":true,"department":[{"@id":"https:\/\/sleepandlungcare.com.au\/respiratory-sleep-physicians-epping\/#clinic"},{"@id":"https:\/\/sleepandlungcare.com.au\/respiratory-sleep-physicians-brunswick\/#clinic"},{"@id":"https:\/\/sleepandlungcare.com.au\/respiratory-sleep-physicians-doncaster-east\/#clinic"},{"@id":"https:\/\/sleepandlungcare.com.au\/respiratory-sleep-physicians-braybrook\/#clinic"},{"@id":"https:\/\/sleepandlungcare.com.au\/respiratory-sleep-physicians-kilmore\/#clinic"}],"physician":[{"@type":"Physician","@id":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-irena-laska\/#physician","name":"Dr Irena Laska","url":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-irena-laska\/"},{"@type":"Physician","@id":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-maitri-munsif\/#physician","name":"Dr Maitri Munsif","url":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-maitri-munsif\/"},{"@type":"Physician","@id":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-jibin-thomas\/#physician","name":"Dr Jibin Thomas","url":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-jibin-thomas\/"},{"@type":"Physician","@id":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-daniel-niewodowski\/#physician","name":"Dr Daniel Niewodowski","url":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-daniel-niewodowski\/"},{"@type":"Physician","@id":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-benjamin-leaver\/#physician","name":"Dr Benjamin Leaver","url":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-benjamin-leaver\/"},{"@type":"Physician","@id":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-bassem-dawood\/#physician","name":"Dr Bassem Dawood","url":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-bassem-dawood\/"},{"@type":"Physician","@id":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-jayne-roberts\/#physician","name":"Dr Jayne Roberts","url":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-jayne-roberts\/"},{"@type":"Physician","@id":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-ashwin-rajan\/#physician","name":"Dr Ashwin Rajan","url":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-ashwin-rajan\/"},{"@type":"Physician","@id":"https:\/\/sleepandlungcare.com.au\/team-member\/mr-bibhusal-thapa\/#physician","name":"Mr Bibhusal Thapa","url":"https:\/\/sleepandlungcare.com.au\/team-member\/mr-bibhusal-thapa\/"},{"@type":"Physician","@id":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-cara-tanner\/#physician","name":"Dr Cara Tanner","url":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-cara-tanner\/"},{"@type":"Physician","@id":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-jessica-nash\/#physician","name":"Dr Jessica Nash","url":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-jessica-nash\/"},{"@type":"Physician","@id":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-raymond-wong\/#physician","name":"Dr Raymond Wong","url":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-raymond-wong\/"},{"@type":"Physician","@id":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-sanjeevan-muruganandan\/#physician","name":"Associate Professor Sanjeevan Muruganandan","url":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-sanjeevan-muruganandan\/"},{"@type":"Physician","@id":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-kanishka-rangamuwa\/#physician","name":"Dr Kanishka Rangamuwa","url":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-kanishka-rangamuwa\/"},{"@type":"Physician","@id":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-julien-robinson\/#physician","name":"Dr Julien Robinson","url":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-julien-robinson\/"},{"@type":"Physician","@id":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-jack-henderson\/#physician","name":"Dr Jack Henderson","url":"https:\/\/sleepandlungcare.com.au\/team-member\/dr-jack-henderson\/"}]}]}},"_links":{"self":[{"href":"https:\/\/sleepandlungcare.com.au\/vi\/wp-json\/wp\/v2\/pages\/2496","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sleepandlungcare.com.au\/vi\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/sleepandlungcare.com.au\/vi\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/sleepandlungcare.com.au\/vi\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/sleepandlungcare.com.au\/vi\/wp-json\/wp\/v2\/comments?post=2496"}],"version-history":[{"count":48,"href":"https:\/\/sleepandlungcare.com.au\/vi\/wp-json\/wp\/v2\/pages\/2496\/revisions"}],"predecessor-version":[{"id":14685,"href":"https:\/\/sleepandlungcare.com.au\/vi\/wp-json\/wp\/v2\/pages\/2496\/revisions\/14685"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/sleepandlungcare.com.au\/vi\/wp-json\/wp\/v2\/media\/9287"}],"wp:attachment":[{"href":"https:\/\/sleepandlungcare.com.au\/vi\/wp-json\/wp\/v2\/media?parent=2496"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}