We're almost finished processing your WatchPat order.

To assist the Sleep & Respiratory Specialist in analyzing your sleep test data please complete this short online sleep health assessment form.

IMPORTANT - Your WatchPat device cannot be dispatched with the delivery carrier until the attached sleep health questionnaire is completed.

Please again provide your name and contact details.

SLEEP APNEA RISK SCORE ASSESSMENT

The following assessment parts are click-based questions designed to collect health and medical information to assist both your GP and Sleep & Respiratory Physician reporting on your sleep test.

Part 1) List Symptoms and Medical Conditions.

Part 2) Complete two sleep health industry-based questionnaires.

The information provided in this form is reviewed by an Australian Sleep & Respiratory Physician as part of your sleep health assessment. This information assists the specialist when analyzing your night of sleep test data and formulating your sleep report.

STOP-BANG Questionnaire

The StopBang questionnaire is an assessment tool to screen for obstructive sleep apnea based on risk factors and symptoms.

Epworth Sleepiness Scale (ESS)

This questionnaire assesses your level of daytime sleepiness based on how likely you are to doze off or fall asleep in various situations.

In the following situations, how likely are you to doze off or fall asleep, in contrast to just feeling tried?

Use the numeric scale below to determine the likelihood of dozing off in each of the situations below:
0 = No Chance | 1 = Slight Chance | 2 = Moderate Chance | 3 = High Chance