Which best describes your sleep?
*
I snore, but sleep normally otherwise
I snore and have symptoms like gasping, pauses in my breathing, or waking up tired
I struggle more with sleep quality
Do you or your partner notice that you snore?
*
Yes
No
How often do you wake up at night?
*
Rarely
Occasionally
Frequently
Almost every night
How often do you feel tired during the day?
*
Never
Rarely
Sometimes
Every day
Are you overweight, have high blood pressure, or diabetes?
*
Yes
No
Based on your responses, you may have sleep apnea and could possibly qualify for a sleep appliance.
If you do
NOT
want to wear CPAP, we just have a few more questions
to see if you qualify to wear a sleep appliance to manage your sleep apnea and snoring.
Click next to get started!
Choose Your Coverage
*
Insured Through Employer
Medicare 65+
State Provided Insurance (Medicaid)
Self-Pay
Have you ever had a Sleep Study?
*
Yes, less than 12 months ago
Yes, 12 - 24 months ago
Yes, more than 24 months ago
No
Have you tried a CPAP?
*
Yes
No
Full Name
*
Email
*
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Cell Phone
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I consent to receive non-marketing text messages such as appointment confirmation & reminders from TMJ & Sleep Solutions of West Virginia about my inquiry. Message frequency varies. Message and data rates may apply. Text HELP to 304-486-3323 for assistance. Reply STOP to opt out.
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