Patient Questionnaire

You have three options for completing a questionnaire:

  • Enter the information on the fillable PDF and click ‘Print’ at the end of the document
  • Print the questionnaire and fill it out by hand
  • Or Fill out the PDF and click ‘Print’. Change your destination to ‘Save as PDF’ and save to your computer.

The Sleep Log and Authorization Signature must be completed by hand.

Please bring the completed questionnaire(s) to the office or sleep lab.

Questionnaire is best filled out using Acrobat Reader

Get it here

Sleep Study Questionnaire

pdficon_small Download Questionnaire

HIPPA Policy

pdficon_small Download HIPPA Policy

PHI Disclosure Form

pdficon_small Download Form

One Week Sleep Log (for MSLT study only)

pdficon_small Download Log