Assess Your Risk of Sleep Apnea
Email address *
Full name as per IC *
Age *
Mobile Number (012-3456788) *
Do you SNORE loudly (louder than talking or loud enough to be heard through closed doors)? *
Do you often feel TIRED, fatigued, or sleepy during daytime? *
Has anyone OBSERVED you stop breathing during your sleep? *
Do you have or are you being treated for high blood PRESSURE? *
BMI > 28kg/m2? *
Age > 50 years old? *
Neck circumference > 38cm? *
Male GENDER? *
I hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I undertake the responsibility to inform you of any changes therein, immediately.
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