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

FOR MORE INFORMATION CALL (888) 844-9845

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SLEEP ASSESSMENT FORMS

Sleep Assessment

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

Phone

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

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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

Phone

Email Address *

First Name *

Last Name *

Phone Number *

Postal Code *

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Sleep Assessment

Total:

INSURANCE INFO (on your insurance card)

Provide Your Contact Info for a Free Consultation