Patient Referral Forms

You can complete the PDF form online, print out and fax to the appropriate Innovative Sleep Centers location.  You may also print a blank form to fill out manually.  If you would like a pad of referral forms, please contact us in the form below and our local provider liaison will deliver them.

Please note that there are separate forms for our California and Washington locations.


California Provider/Community Liaisons

Veronica Walker
Chico/Yuba City, CA

Phone: 530.591.3411

Steve Siders
Redding, CA

Phone: 530.227.6272

Washington Provider/Community Liaisons

Dana Ochsner, LPN
Tumwater, WA

Phone: 360.701.6644

Kevin Sprouffske
Aberdeen and Chehalis, WA

Phone: 360.581.8034

Public Relations/Patient Engagement/Marketing

Kalei C. LaFave
Phone: 360.431.5214


Contact Us

If you are interested in learning more about advancements in sleep medicine or detailed information on our services, please call or contact us in the form below.  One of our local provider liaisons would be happy to arrange an educational presentation with your staff.

If you are a current referring provider, we would like to hear from you on our patient interactions, services, and products.  We are always interested in collaborating on new initiatives to increase patient satisfaction and quality of care.  

Please complete the form below

Name *
Phone *