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Refer a friend

Know a friend, relative, or co-worker who may be interested in this product? Take this opportunity to let them know.
PATIENT'S DETAILS
Title*
First Name*
Surname*
Address*
NHI
Date of Birth*
Example: 29/03/1969
Phone (H)*
Example: (649)845-0088
Phone (W)
Example: (649)845-0088
Mobile
Example: (64)21-456789
TEST REQUESTED (Patients should withhold inhalers on the day of the test)
Spirometry with Flow/Volume loops
Pre and post bronchodilator
Lung volumes and flows with DLCO
Pre and post bronchodilator
Exercise VO2 assessment
6 minute walk test
Static mouth pressures (for muscle weakness)
Challenge testing
Tidal breathing (for Hyperventilation Syndrome)
Arterial blood gas (Home O2 assessment)
Hypoxic challenge for flying
Induced sputum
FENO

Clinical Details

Referring Doctor
Referring Doctor*
Phone*
Example: (649)845-0088
Date*
Example: 23/01/2010
Fax
Address
The Message.
Hi, You're receiving this email because {name} thinks the Respironics Amara Full Face Mask would interest you.

Amara's innovative, modular design is lighter, smaller, and has significantly fewer parts than leading traditional full-face masks. In fact, it requires just a single click to disassemble and reassemble the cushion and the mask frame for quick cleaning and replacement.

Performance
• As our best sealing and most comfortable traditional full-face mask yet, Amara is designed to enhance your quality of sleep.
• Customise and fine-tune the seal of your mask using the fine-glide forehead adjuster.

Appeal

• Amara was designed with you in mind. As the smallest leading traditional full-face mask on the market, it is less likely to get in the way of a good nights sleep.

• Less intimidating design.

Simplicity
• Amara’s one-click cushion attachment gives you confidence that the mask is correctly assembled. 
• With only four parts, assembly and cleaning are quick and easy so that you can spend more time doing the things you love.

For more information, please click Here Regards,
Bracketed text e.g {name} indicates details that will be completed by the system when you click the submit button.

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Contact Us

 
PHONE                  09 638 5255
FREEPHONE       0800 895 120
FAX                        09 638 6022

referrals@nzrsi.health.nz

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GREENLANE
NZ Respiratory & Sleep Institute
Ascot Office Park 
Level 3, Building B
93-95 Ascot Avenue
Greenlane East
Auckland 1051
New Zealand

NORTH SHORE
Northshore Medical Specialists
326 Sunset Road
Windsor Park
Auckland
New Zealand
PUKEKOHE
NZ Respiratory & Sleep Institute
2B Glasgow Road
Pukekohe 2120
New Zealand




POSTAL ADDRESS
PO Box 109 409
Newmarket
Auckland 1149
New Zealand