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Sleep Apnea Assessment

Are you considering choosing a sleep appliance to treat sleep apnea? Find out your ‘sleep apnea score’ by answering a few quick questions on the form below. Please note – We are not a sleep apnea testing facility.

Sleep Apnea Test

* Required Field

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

We respect your privacy and will not share your contact information with anyone.

For Free Sleep Apnea Assessment
Call 248-827-1144
or request an appointment online

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