Dental Services | Sana Dental | North Edmonton Dentist | Edmonton, AB

Take our Sleep Disorder Questionnaire. It's Easy!

  • Fill Out Our Sleep Disorder Questionnaire
  • We Will Process Your Information
  • We Will Contact You Within 48 Hours (Weekdays Only)
Please Contact Me by(Required)

RATE YOUR SLEEP DISORDER

Please answer the questions below to rate the likelihood of you DOZING or FALLING ASLEEP in the following situations, in contrast to just feeling tired.
In a car, while stopping for a few minutes in traffic(Required)
As a passenger in a car for an hour without a break(Required)
Sitting and reading(Required)
Lying down to rest in the afternoon(Required)
Sitting inactive in a public place (i.e. movie or meeting)(Required)
Sitting and talking to someone(Required)
Do you snore?(Required)
Sitting quietly after a lunch without alcohol(Required)
Has anyone noticed that you quit breathing during your sleep?(Required)
During your awake time, do you feel tired, fatigued, or not up to par?(Required)
How often do you feel tired or fatigued after your sleep?(Required)
How often does this occur?(Required)
Have you ever nodded off or fallen asleep driving a vehicle?(Required)
Do you have high blood pressure?(Required)
This field is for validation purposes and should be left unchanged.

We look forward to hearing from you soon!

Call us at (780) 476-3391 to set up your Sleep Disorder Questionnaire today!