Do You Have Sleep Apnea? Take Our Free Online Sleep Assessment Quiz

FOR MORE INFORMATION CALL (888) 844-9845

About
Testimonials
Sleep Apnea
- Myths & Facts
- Treatments
Oral Appliance
Blog
Locations

SLEEP ASSESSMENT FORMS

Sleep Assessment

Please Answer the questions below. Your score will automatically be totaled at the bottom of the page.

Company

I've been told that I snore *

True False

I've been told that I stop breathing while I sleep, although I don't remember this when I wake up *

True False

I have high blood pressure *

True False

My friends and family say they have noticed changes in my personality *

True False

I am gaining weight *

True False

I sweat excessively during the night *

True False

I get morning headaches *

True False

I have trouble sleeping when I have a cold *

True False

I suddenly wake up gasping for breath during the night *

True False

I am overweight *

True False

If you scored 30 or higher you show symptoms of Sleep Apnea, a life-threatening disorder that causes you to stop breathing repeatedly – often several hundred times per night – during your sleep.

Total:

First Name *

Last Name *

City *

State *

Phone Number *

Email Address *

INSURANCE INFO (on your insurance card)

Birthday

Ins. Policy Number

Provider Phone Number

info@soundsleepmedical.com
(888) 844-9845

Treatments | About | News | Contact | Facebook

North Ogden:
1075 North Washington Blvd., Ogden, UT 84404
(801) 528-4889

Provo:
3216 N University Ave, Provo, UT 84604
(801) 615-2674

Sandy:
8941 South 700 East Suite 204, Sandy, UT 84070
(801) 937-4719

St. George:
640 East 700 South, Building 2, St. George, UT 84770
(435) 275-4624

About
Testimonials
Sleep Apnea
- Myths & Facts
- Treatments
Oral Appliance
Blog
Locations

About
Testimonials
Sleep Apnea
- Myths & Facts
- Treatments
Oral Appliance
Blog
Locations

Provide Your Contact Info for a Free Consultation

Company

Email Address *

First Name *

Last Name *

Phone Number *

Postal Code *

MENU

MENU

Sleep Assessment

Total:

INSURANCE INFO (on your insurance card)

Provide Your Contact Info for a Free Consultation