Sleep Disorder Questionnaire

Sleep Disorder Questionnaire | Health Style Dental

Are you experiencing any issues with snoring, sleep apnea or using a CPAP machine? Please fill out the form below and we will follow up with you to address your issues with some helpful insights. 

Part 1: Your Contact Information

Please provide us with the following information so we can follow-up with you within 48-hours.

Part 2

Please rate each of the following situations based on how likely you are to doze or fall asleep (just feeling tired).

Part 3