• Patient Intake Questionnaire (pdf)

The above Patient Intake Questionnaire should be downloaded to your computer (3.8mb) and then filled out in it’s entirety using Adobe Reader. You may right click on the file link above (control + click for mac) and save it that way or if you have your browser configured to open Adobe Reader for .pdf documents automatically, you can go ahead and fill out the form then and just save it to your computer afterward.

When you open the file you should see a pink or purple section across the top of the page. If they are not highlighted already, you may click the button in that pink/purple area to highlight all the fields that are to be filled in. Once you have finished filling out your Questionnaire, you should save it to your computer and then click the “Click to Send by Email” button at the bottom of the last page (*Mac users using Preview to view .pdf documents may find that the document does not behave as described.).

This will open a new email in your email program addressed to our sleep center with the questionnaire file you saved already attached and ready to go. You may either just add a subject and hit send or also add a note for us before the attached file if you wish.

The file is rather large, so don’t fret if it takes some time for the email to be sent.