Sleep health screening.

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Welcome to our screening tool. Please fill in the following form, and we will send your report to your email address. We will send the report as soon as possible, but please allow one business day for processing.

By entering your details below, you accept the following:

I have entered the information truthfully and to the best of my knowledge.

I consent for my information to be stored, processed, and for a report to be sent to me.

Full name:

The first questionnaire is the Stop-Bang Questionnaire below.

Do you snore loudly?

Louder than talking, or load enough to be heard through closed doors.

Yes

Do you often feel tired, fatigued, or sleepy during the daytime?

Yes

Has anyone observed you stop breathing during your sleep?

Yes

Do you have or are you being treated for high blood pressure?

Yes

How much do you weigh? (kg)

What is your height? (cm)

Are you over the age of 50?

Yes

Is your neck circumference over 40cm? (16 inches)

Yes

What sex were you assigned at birth?

Male

Female

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