Sleep Assessment
Sleep Assessment
Sleep Assessment
Please consider how likely you are to doze off or fall asleep in the following situations, rather than just feeling tired. Think about your usual daily life over recent times. Even if you haven’t experienced some of these situations recently, try to estimate how they would likely affect you.
*Mobile users may need to rotate device to complete the form.
Use the following scale to respond to each situation:
0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
Complete the form below to provide your responses.
Please consider how likely you are to doze off or fall asleep in the following situations, rather than just feeling tired. Think about your usual daily life over recent times. Even if you haven’t experienced some of these situations recently, try to estimate how they would likely affect you.
*Mobile users may need to rotate device to complete the form.
Use the following scale to respond to each situation:
0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
Complete the form below to provide your responses.
Our team will review your responses and reach out to you soon to discuss your score. They will help determine whether a sleep study may be beneficial for you and guide you through the next steps toward better sleep health.
Having Trouble Sleeping?
Having Trouble Sleeping?
