• Pay Your Bill
  • Forms
  • Patient Portal
  • Locations

Neurology Center of Fairfax

703-876-0800
To report a problem with the functionality of this website, please email domain@ncfx.net. This email address does not accept any medically related communication nor is it monitored on a daily basis.
  • Patient Forms
  • Tests Offered
  • Test Instructions
  • Home
  • Physicians & Practitioners
  • Specialties
    • Alzheimer’s disease
    • Concussion
    • Dementia
    • Dizziness
    • Dystonia & Spasticity
    • Migraine Headaches
    • Multiple Sclerosis
    • Neck & Back Pain
    • Nerve & Muscle Disorders
    • Parkinson’s Disease
    • Peripheral Neuropathy
    • Sleep Disorders
    • Stroke
  • Services
    • Ambulatory Electroencephalography
    • Cognitive Testing
    • CPAP Titration
    • Duplex Carotid Ultrasound Studies
    • Electroencephalography
    • Electromyography & Nerve Conduction
    • Evoked Potential Tests
    • Home Sleep Studies
    • Infusion Center
    • Multiple Sleep Latency Test
    • Non-Invasive Vascular Studies
    • Polysomnogram
    • Vascular Testing
  • Resources
  • Contact & Information
    • Appointments
    • Patient Portal
    • Prescriptions
    • Records & Referrals
    • Billing & Authorizations
    • Surprise Billing Protections 
    • Good Faith Estimate
    • Insurance Plans
    • Careers
  • forms-header

Packet: Polysomnogram – CPAP Testing

Instructions:

Please fill the following 6 forms prior to your appointment. Documents not submitted 7 days in advance of your appointment may not be available to your doctor at the time of your appointment. Thank you.

Sleep Study Guidelines
Sleep Health Questionnaire
Feelings Survey
Permission to Record
Medication List
Consent for Polysomnogram

If we do not have a copy of your most recent government ID or insurance card/s, please upload them here.

File Upload Form

For Your Information

To Our Patients…(PDF)
What to expect… (PDF)
Sleep Study Info (PDF)
Mask Cleaning Instructions (PDF)
Sleep Apnea FAQ (PDF)
CPAP FAQ (PDF)
Medical Records Request (PDF)

To open and view the PDF forms above, download the free Acrobat Reader.


Return to all forms…

Locations

Fairfax Office
3020 Hamaker Ct, Suite 400
Fairfax, VA 22031

703-876-0800 | Fax: 703-876-0866
Reston Office
1830 Town Center Drive, Suite 305
Reston, VA 20190

703-876-0800 | Fax: 703-876-0866
Sleep Diagnostic and Treatment Center
3020 Hamaker Ct, Suite 400
Fairfax, VA 22031

703-876-2850 | Fax: 571-308-1158
  • Notice of Privacy Practices
  • Disclaimer
  • Contact & Information

© 2025 Neurology Center of Fairfax
Created by Synergy Marketing