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.
It is always a pleasure to welcome your patients, and I am particularly grateful for your trust in my abilities to provide them care.
I will do my best to ensure that they have a positive experience and that their needs are met. I appreciate your confidence in my practice, and I look forward to working with you and your patients in the future.
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.