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Patient Information




    STOP-BANG Sleep Apnea Questionnaire

    STOP

    Do you SNORE loudly (louder than talking or loud enough to be heard through closed doors)?

    YesNo

    Do you often feel TIRED, fatigued, or sleepy during daytime?

    YesNo

    Has anyone OBSERVED you stop breathing or choking/gasping during your sleep?

    YesNo

    Do you have or are you being treated for high blood PRESSURE?

    NoYes

    BANG

    BMI Calculation inputs:

    Height: Ft In

    Weight (lbs):

    AGE over 50 years old?

    YesNo

    NECK Circumference:

    Neck size (inches):

    GENDER: Male?

    YesNo

    Express Medical Solutions
    Please contact us for more information or to sign up for your overnight sleep test and treatment.

    Mailing Address
    Address: PO Box 945
    Brentwood, TN 37024

    Phone: 563-900-8770
    Email: info@expressms.net