[2:20] Appointment Request
MedStar Georgetown University Hospital

Request an Appointment for a Sleep Study

Thank you for choosing MedStar Georgetown University Hospital for your healthcare services. To request an appointment with a MedStar Georgetown University Hospital Sleep Study specialist, please fill out the form below.

If you are experiencing a medical emergency, please call 911 immediately.

Sleep studies are medical procedures which require a physician order to conduct. If you do not have a physician order, please schedule a Pulmonary appointment here .

This appointment request form is secured, and the information that you provide is confidential. If you prefer to speak with MedStar Georgetown M.D. (medical directory) nurse counselor who can schedule your appointment with one of our expert physicians, please call 202-342-2400 or 866-745-2633. Nurse counselors are available Monday through Friday, 8 a.m. to 8 p.m. Please note: We are not able to provide any medical diagnoses or consultations via phone or e-mail.

* required information

Requestor Information
I am requesting this appointment for someone else
Daytime Phone Number 
What is the best time to contact you? 
How did you hear about us? 
Would you like to receive health-related information from MedStar Georgetown University Hospital? 

Patient Information
First Name * MI Last Name
Home Address *    
City * State * Zip Code *
Date of Birth * Gender
Reason for Contact* 
  Sleep Apnea Snoring Insomnia Excessive Daytime Sleepiness
  Night Time Movement Disorders Other
Please describe your symptoms and/or existing medical condition.

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How long have you had these symptoms?

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Have you been treated for this condition in the past?
Yes No
Have you had any previous sleep studies?
Yes No
Do you have current medical work-ups (MRI, x-rays, etc.) performed in the last 3 months?
Yes No
Health Insurance Provider
Insurance ID
Insurance Group Number

Please note: When you register at any MedStar Health site, your information remains strictly confidential. As always, MedStar Georgetown University Hospital and its parent company, MedStar Health, respect your privacy. The information you submit is used for internal purposes only to help guide us in developing health information relevant to your needs. Read our privacy policy.