Patient Questionnaires

Download the Epworth Sleepiness Scale Questionnaire and select your physician questionnaire. Fill out both forms and bring them with you to your visit.

  • The Epworth Sleepiness Scale Questionnaire – PDF | RTF
  • Dr. Polk Patient Questionnaire – PDF | RTF
  • Dr. Mooring Patient Questionnaire – PDF | RTF

If your score is more than 10, you may have a sleep disorder and it is recommended that you seek the advice of a sleep specialist without delay.