New Patient Information - Appointment

Welcome to the DreamDocs Patient Registration portal. Please provide the information requested below to sign up for a Sleep Telemedicine Consult with a board certified licensed physician in your state.

Last Name: * First Name: * Date of Birth: *

Sex: * M F State: * Preference: *

Home Phone:

Cell Phone: *

E-mail Address: *

I agree to receive the follow up consultation notes and any orders for testing or equipment by email following my appointment in an unencrypted email format which is not HIPAA compliant.

* required fields