About Us
Meet the Doctor
Our Philosophy
Sleep Apnea
About Sleep Apnea
Causes
Risks
Snoring
Sleep Disorder
Sleep Test
Do I Have Sleep Apnea?
Solutions
Treatments for Sleep Apnea
Diagnostic Services
Sleep Oral Appliances
Recommended Sleeping Aids
New Patients & Referrals
Patient Forms
Insurance
Referring Physicians
Resources
Pay Online
Videos
Blog
Follow-Up Forms
Testimonials
FAQs
Recommended Products
Contact Us
Pay Online
Denver, CO
(303) 758-4865
About Us
Meet the Doctor
Our Philosophy
Sleep Apnea
About Sleep Apnea
Causes
Risks
Snoring
Sleep Disorder
Sleep Test
Do I Have Sleep Apnea?
Solutions
Treatments for Sleep Apnea
Diagnostic Services
Sleep Oral Appliances
Recommended Sleeping Aids
New Patients & Referrals
Patient Forms
Insurance
Referring Physicians
Resources
Pay Online
Videos
Blog
Follow-Up Forms
Testimonials
FAQs
Recommended Products
Contact Us
Pay Online
(303) 758-4865
Sleep Assessment Quiz
Home
>
Sleep Apnea
>
Sleep Assessment Quiz
Have you been told you snore?
(Required)
Select…
Yes
No
Do you have any of these health conditions?
High Blood Pressure
Diabetes
Coronary Artery Disease
Shortness of Breath
Do you dream?
(Required)
Select…
Yes, Every Night
No
Not sure
Have you ever been diagnosed with sleep apnea?
(Required)
Select…
Yes
No
How would you describe your sleep?
(Required)
Select…
Insufficient - Always Tired
Restful
Disruptive
Do you experience any of the following conditions?
Excessive daytime sleepiness
Insonia
Restless leg syndrome
Do you work at night?
None of the above
Do you have a CPAP?
(Required)
Select…
Yes, Use Every Night
Yes, Rarely Use
No
How did you hear about Denver Sleep Apnea Center?
(Required)
Select…
My Physician’s Office
My Dentist
Google
Sleep Assessment Card
Email
Family or Friend
Radio
Social Media
Fill in your personal details
First Name
(Required)
Last Name
(Required)
Email
(Required)
Phone
(Required)
Gender
Gender
Male
Female
Age
Weight
Δ
Contact Us
Visit Us
Please ensure Javascript is enabled for purposes of
website accessibility