Submit Payment

Do you have an invoice?

Click the appropriate payment button below.

Before you proceed, please check your email (including SPAM) and see if you received an invoice.

WHAT TO SEARCH FOR:

from: [email protected]
subject contains:
Invoice from Sleep Well Anesthesia

I received an invoice email
I do not have an invoice

Anesthesia Patient Forms

We are committed to safeguarding your comfort throughout this process

Check the boxes to keep track of your progress.

This short checklist has links to help you ensure that you’ve completed all of your pre-procedural forms.

Pay your invoice in the customer portal.
      If you did not receive an invoice via email, submit payment here.

Review the Informed Consent form that you will sign in person on the day of your procedure.
Fill out the Medical History Questionnaire.
Acknowledge that you have read the Pre-Anesthesia Instructions.
Acknowledge that you have read the Post-Anesthesia Instructions.
Fill out the HIPAA Privacy Policy Form so that we know how you would like to be contacted.