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Upload your X-rays/Forms

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Name of patient

Date of X-ray

Referral


Patient Referral Form

At Raamya Dentistry, we value our relationships with our clients. If you would like to refer a client to our practice, please fill out the form below, or you can use our printable referral form. One of our team members will get in touch with you soon. Thank you for recommending our practice!

Patient Referral Form

Patient name*

Date *

Female/Male *

Phone number *

Date of birth*

I am referring our patient for the following symptoms (please check all that apply):

I am specifically concerned about the following condition(s)

Panoramic Radiography Attachment

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Date of the Panoramic Radiography

Doctor

Date*

Phone number*

Fax*

If you’re using a hard copy of the form, please return consultation request to: Fax: 905-997-1890

Symptoms and Conditions Linked to Sleep Apnea

You stop breathing when your airway or windpipe collapses completely. The absence of oxygen forces your brain to wake up from sleep. Although you may not know that you had stopped breathing, you may feel unease when you wake up. If you have mild sleep apnea, you may stop breathing a couple of times in an hour. But in severe cases, you may stop breathing as many as 30 times an hour or more. The sleep apnea appliance holds your lower jaw in a forward position. So, your jaw does not shift or fall open during the night, thereby preventing your airway from collapsing. Don’t worry about your breathing problem; we are here for you. Schedule your appointment today!

A person experiencing sleep apnea may have:

  • Chronic sleepiness

  • Morning headaches

  • High blood pressure

  • Heart attack

  • Stroke

  • Heartburn

  • Depression

Snoring not only affects the quality of your life and that of your sleeping partner but can also be linked to many health disorders. However, you don't have to compromise with your life. Raamya Dentistry provides services for the treatment of snoring and obstructive sleep apnea. Contact us today!

Our Practice

Rely on us for treatment of snoring and sleep apnea, orofacial pain, and TMD/TMJ dysfunction in Mississauga.

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