Patient Referral Form
Dear MFT, SLP, IBCLC Providers,
I believe MFT, SLP and IBCLC play a crucial role in helping patients to resolve issues related to oral muscle function, correcting improper swallowing patterns, tongue posture and other oral habits. At Arizona Sleep and Breathing, we identifies potential muscle dysfunction during oral examinations, like tongue thrusting or mouth breathing, speech impairment due to tongue restrictions and lack of tongue tone resulting in narrow upper arch in infant and adult patients.
Thank you for entrusting me with the care of your patients. It is always a pleasure to collaborate with you, and I appreciate your confidence in my ability to provide care for them. I am committed to ensuring that your patients have a positive experience and receive the highest quality care. I value our partnership and look forward to continuing to work together.
Please fill the downloadable referral form and fax to 520-299-1739, You may also scan and email to merchant@arizonasleepandbreathing.com, or submit the form online.