Leads | Caribbean Sleep Apnea Solutions

Fill out the following questionaire

How likely are you to doze off or fall asleep in the situations described below, in contrast to feeling just tired?

Sitting and reading*

Watching TV*

Sitting, inactive in a public place*

While stopped for a few minutes in the traffic*

As a passenger in a car for an hour*

Lying down to rest in the afternoon*

Sitting and talking to someone*

Sitting after a lunch without alcohol*

Epworth Score

Do you currently suffer any of the following conditions?

Loud Snoring?*

Daytime Sleepiness?*

Additional Symptoms*

Symptoms - Risk Score

How did you hear about us?*

Other

Were you referred by one of our Accredited Screening Centre's - ASC?*

Select Accredited Screening Centre*

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