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How would you describe your current sleep pattern (check all that apply)?

I have trouble falling asleep

I wake up during the night and can’t fall back asleep

I wake up too early and can’t get more sleep

I sleep through the night but still feel tired

None of the above

On average, how many hours of sleep do you get per night in total?

How long have you been experiencing sleep difficulties (# of months/yrs)?

Have you ever been diagnosed with sleep apnea, restless leg syndrome (RLS), or another sleep disorder?

Are you 100% sure you can make it at your chosen time? If you're unsure, it's better to pick another time now. We want to respect your time, please respect ours. *

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