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Sleep Apnea Risk Awareness Survey | MemorialCare Sleep Disorder Center | Long Beach Memorial Medical Center
Sleep Disorders

Sleep Apnea Risk Awareness Survey

Complete the online sleep apnea risk awareness survey below by answering Yes or No.
Sleep Apnea Risk Awareness Survey
Answer yes or no: Yes No
Do you awaken more than once at night to urinate?
Do you snore?
Does your partner tell you that you stop breathing when you sleep?
Do you wake up gasping at night?
Do you feel "worse" when you wake up?
Do you feel sleepy during the day?
Do you have high blood pressure?
Are you more than 30 pounds overweight?
Do you suffer from morning headaches?
Has your concentration, memory, or temper (irritability) been worsening?
  1. The risk assessment is not diagnostic and is not a substitute for an examination by a physician.
  2. The data derived from the risk assessment is to be considered as preliminary only, and in no way conclusive.
  3. The responsibility for any follow-up examination lies with me and not with any participating organization, employee, volunteer or individuals.
  4. I am responsible for my own health and it is my sole responsibility to follow through on any and all identified risk factors by obtaining appropriate medical attention and advice.
     
 

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MemorialCare Health System is rank in SDI's 2011 Top 100 IHNs
 
MemorialCare Health System Among 29 Major Employers Worldwide Receiving 2011 Gallup Great Workplace Award
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MemorialCare Health System is a not-for-profit integrated delivery system that includes six top hospitals – Long Beach Memorial, Miller Children's Hospital Long Beach, Community Hospital Long Beach, Orange Coast Memorial, and Saddleback Memorial Laguna Hills and San Clemente; medical groups – MemorialCare Medical Group and Memorial Prompt Care; an Independent Practice Association (IPA) – Greater Newport Physicians; MemorialCare HealthExpress retail clinics; and numerous outpatient health centers throughout the Southland. Our community-based hospitals are located in Southern California in both Los Angeles County and Orange County. Copyright © 1999 - 2013, Memorial Health Services. All rights reserved.