Downloadable Forms
In order to expedite your Sleep Clinic and Sleep Lab visits, please print and fill out your forms prior to your Sleep Clinic or Sleep Lab appointment. If you have never been to either the sleep clinic or sleep lab, please fill out all the forms listed in the "New Patient Forms" area below.
If you have never been seen by a sleep physician in our clinic and are about to undergo a sleep study, please print and fill out from both the "New Patient Forms" area AND the forms found in the area of the appropriate sleep study you are about to undergo. If you are an established patient with our clinic or lab and are about to undergo a study, please pick the forms to the sleep study you are about to have.
Note: Epworth Sleepiness Questionnaires are meant to be filled out in response to how tired you feel on the day of your appointment. This may need to be repeated on subsequent appointments. If you have any questions about which forms need to be completed, please call us at (757) 953-7781.
New Patient Forms
- Required for ALL patients who have never been to the Sleep Clinic or Sleep Lab.
Home Sleep Study Forms
- For patients about to undergo an unmonitored sleep study in your own residence.
Polysomnogram (PSG) Study Forms
- For patients about to undergo a monitored sleep study at the sleep lab. The CPAP mask may or may not be given to you in the second half of the night.
Polysomnogram (PSG) & Multi-Sleep Latency Test (MSLT)
- For patients who are being evaluated with a nighttime study followed immediately by a series of 4 to 5 periods of sleep the following day. This is to look for narcolepsy.
Maintenance of Wakefulness Test (MWT)
- This is a daytime study where you are asked to remain awake in the dark. This is a test generally given to evaluate your ability to stay awake as part of a safety evaluation for those involved in high-risk occupations.
CPAP Titration Study
- This is a study, normally done only after a previous sleep study has already been performed, where the sleep lab will determine the amount of pressure applied through a mask that you will need to treat your obstructive sleep apnea.