Sleep Apnea Assessment — duplicate-consumer51

Sleep Apnea Test

This form determines the need for you to have a sleep test, which will evaluate if you have a sleep disorder. Sleep Disorders negatively affect your cardiovascular health and well being, but can be effectively treated.   


Part 1
Part 2
Epworth Sleepiness Scale


How likely are you to doze off while doing the following activities?  Please use the following scale:  0 = never, 1 = slight, 2 = moderate, 3 = high.  Select  one of the following numbers


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