Healthcare Providers: Join Our International Directory

Prefix

First Name *

Last Name *

Suffix

I hold the following degree(s) *
Please check all that apply.
  MD
  DO
  PhD
  MBBS
  ChB
  Other

Organization

Address *

City *

State/Province *

Zip/Postal Code *

Country *

Email *
Although we are requesting this information, we will not be publishing your email address

Phone *

Website (enter n/a if you don't have a website) *

Specialty *
Please check all that apply.
  Sleep Medicine
  Neurology
  Pulmonary/Critical Care
  Psychiatry
  Otolaryngology
  Internal Medicine
  Pediatrics
  Family Medicine
  Anesthesiology
  Other

I treat patients with the following conditions *
Please check all that apply.
  Idiopathic Hypersomnia
  Kleine-Levin Syndrome
  Narcolepsy
  None of the Above

Number of patients (new and returning) I treat in a month with idiopathic hypersomnia *Select one...01-56-1011-1516-2021+

Number of patients (new and returning) I treat in a month with Kleine-Levin syndrome *Select one...01-56-1011-1516-2021+

Number of patients (new and returning) I treat in a month with narcolepsy *Select one...01-56-1011-1516-2021+

I am accepting new patients *Select one...YesNo

I treat *
Please check all that apply.
  Adults
  Children

I conduct clinical research on hypersomnia *Select one...YesNo

By submitting this form, I agree to have my information added to the Hypersomnia Foundation's Healthcare Provider Directory. I understand that inclusion in the directory does not imply endorsement by the Hypersomnia Foundation. *
  I Agree

I would like to receive complementary brochures from the Hypersomnia Foundation to distribute in my office.
  Yes

I would like to receive complementary IH medical alert cards from the Hypersomnia Foundation to distribute in my office.
  Yes

Submit