Sleep Disorder Questionnaire

  • :
  • Rate Your Sleep Disorder

    0 = no chance of dozing
    1 = slight chance of dozing
    2 = moderate chance of dozing
    3 = high chance of dozing

  • Please indicate from 0 - 3 the chance of dozing in each scenario below.

  • Please add up all of your responses and enter the total below.

  • 1 – 6 - Congratulations, you're getting enough sleep!
    7 – 8 - Your score is average
    9 and up - Please seek advice from Deldar Dental without delay
  • This field is for validation purposes and should be left unchanged.

We will contact you back with recommendations and whether it’s necessary to come in for an appointment or a consultation.