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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 Aveo Tongue Stabilising Device (TSD) would interest you. Please note that the AveoTSD is non-refundable if the packaging has been opened and/or if the product has been used, for health and safety reasons. 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

NORTHSHORE
Northshore Medical Specialists
326 Sunset Road
Windsor Park
Auckland
 
PUKEKOHE
NZ Respiratory & Sleep Institute
2B Glascow Road
Pukekohe 2120




POSTAL ADDRESS
PO Box 109 409
Newmarket
Auckland 1149