Sleep Care Solutions

                                   Your sleep dream team

Printable Sleep Quiz

Are you a candidate for a sleep study?

Answer the questions on this quiz,   print it using your browsers print button and then take it to your doctor to find out.

  • Do you get tired or sleepy while you are sitting, reading, watching TV or driving?

    Yes
    No

  • Have you been told that you snore?

    Yes
    No

  • Are you overweight and find it difficult to lose weight?

    Yes
    No

  • Are you diabetic?

    Yes
    No

  • Do you have high blood pressure?

    Yes
    No

  • Do you suffer from chest pains or shortness of breath?

    Yes
    No

  • Do you wake up with leg cramps or sore extremities?

    Yes
    No

  • Are you tired and lethargic during your work day?

    Yes
    No

  • Do you ever wake up with a headache?

    Yes
    No

  • Are you depressed?

    Yes
    No

  • Do you experience GI reflux at night?

    Yes
    No

    If you answered "Yes" to any of these questions, you may be a candidate for a sleep study. Only your physician can make this determination and your answers to these questions will aid in determining your symptoms.

    Order:    Baseline       Split
    DX:   780.53

    Physician Signature: Signature:

    Date: _______________________
  • Main Number
    800-830-4321

    Miami Sleep Lab:
    5995 SW 71 Street Suite 3A
    Miami, FL 33143
    305-666-8800

    Nashville Sleep Lab:
    5211 Linbar Drive, Suite 508
    Nashville, TN  32714
    615-331-5011
    Fax: 615-885-9751

    Central Florida Sleep Lab:
    1561 W. Fairbanks Ave. Suite # 102
    Winter Park, FL 32789
    407-249-1002  
     Fax: 407-249-1005