Registration

I authorize any holder of medical or other information about me to release to the insurance companies any information needed to determine these benefits or benefits for related services . I also authorize the payments from these insurance companies to be paid directly to Somnos Laboratories Incorporated for services provided. I realize I will be responsible for any amount the insurance company does not allow for the services. To the best of my knowledge , the facts stated herein are complete and true.

I hereby authorize Somnos Laboratories Incorporated to obtain any medical information or records which will aid in the diagnosis or treatment of my illness. I also authorize Somnos Laboratories Incorporated to release any information acquired in the use of my testing to other physicians or to insurance companies .

I give consent for Somnos Sleep Disorder Center to send me emails/text messages regarding my account balance.