We won't rest till you do...
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I hereby authorize direct payment of consultations/sleep study benefits to Dr. Gonzalo Diaz/ El Paso sleep Center for services rendered by him/her in person or under his/her supervision. I understand that I am financially responsible for any balance not covered by my insurance.
During the course of your treatment at the El Paso sleep Center the doctor may prescribe a CPAP unit for you to use at home. If the op Paso sleep Center is not in the network of your particular insurance, the old Paso sleep Center will forward your information to a medical equipment company to provide you with any medical equipment that may be necessary.
I authorize El Paso sleep center to release patient information to a medical equipment company that would be able to further assist me in regards of receiving the CPAP unit or any other medical supplies.