Home Sleep Study (ARES DEVICE) Instruction and Agreement Form

    At Pulmonary Practice Associates, we strive to improve our patients’ health by staying current in both our techniques and diagnostic equipment. Our home sleep study technology allows you, the patient, to have your sleep studied in the comfort of your own home. We are excited to provide this easy-to-use technology as an economical solution to our patients.

    Use Responsibility:

    I, the patient, understand that while the monitoring device is in my possession, I agree to exercise care in its use and handling, and return the device within the promised time frame in working condition. I understand that delays in its return will cause problems for other patients who need this service as well.

    Financial Responsibility:

    I the undersigned patient, understand that if the device is lost, stolen or damaged while in my possession, I am financially responsible to pay Pulmonary Practice Associates the current market price for the replacement of this device. The estimated cost for replacing the home sleep test device is $700.00.

    I am checking this device and I agree to return it on (date) before 11:00 am at the conclusion of my sleep study so that other patients may have the same opportunity to be tested. If I do not return it by the date above, I agree to pay a $50.00 late fee per day until the equipment is returned.

    Due to the comprehensive nature of our Home Sleep Study processes and the limited availability of appointments a $100.00 fee will be applied for any missed appointments. To avoid this fee, we kindly ask that you contact us to reschedule or cancel at least 96 business hours (4businnes days) before your scheduled arrival time.

    Date: . Patient Name:

    Date of Birth: .

    Pick Up Home Sleep Study:

    Date: . Time: 2:00 pm – 4:00 pm.

    Drop Off Home Sleep Study

    Date: . Time: 8:00 am – 11:00 am.


    Testing Locations

    749 Stirling Center Place Lake Mary, FL 32746
    Phone: (407) 321-8230

    1075 Town Center Drive Orange City, FL 32763
    Phone: (386) 917-0333

    8400 Red Bug Lake Road Suite 2010
    Oviedo, FL 32763

    Phone: (407) 321-8230

    ABOUT US

    When it comes to breathing disorders, our physicians and staff at Pulmonary Practice Associates understand how important it is for you to choose a qualified physician who will provide the best care possible to get you back to living a healthy and comfortable life.


    1075 Town Center Dr, Orange City, FL 32763
    Phone Number: (386) 917-0333
    Fax Number: (386) 917-0335

    749 Stirling Center Place, Lake Mary, FL 32746
    Phone Number: (407) 321-8230
    Fax Number: (407) 321-0388

    8400 Red Bug Lake Road, Suite 2010, Oviedo, FL, 32765
    Phone Number: (407) 321-8230
    Fax Number: (407) 321-0388

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