At OSA, we realize our patients lead busy lives. We're here to make your experience with us as easy and convenient as possible. The following forms may be downloaded and printed to save time filling them out at our office before your appointment.
Patient Forms and Packets
Download New Patient Packet - Print and fill out before your initial consultation with the doctor.
Download Pediatric New Patient Packet - For parents of pediatric patients, print this and fill out before initial consultation with the doctor.
Download Direct Referral New Patient Packet - For patients who have not had a consultation and are just having a sleep study, print and fill out before sleep study.
Download Direct Referral Physician Order Form - For physicians who would like to refer their patient for a sleep study.
OSA Sleep Questionnaire
The OSA Sleep Questionnaire is a series of questions filled out by all patients that are treated by Oregon Sleep Associates. It provides our physician with a valuable picture of the patient's past medical history and current lifestyle related to sleep.
Epworth Sleepiness Scale
The Epworth Sleepiness Scale is a general measurement of a person's perceived level of sleepiness. It is used to estimate whether there is an excessive level of daytime sleepiness in a person's life. This scale is normally filled out by all of our patients and can be printed out and completed here for use when coming to our clinic.
The Berlin Sleep Questionnaire is a proven screening tool used by health professionals to determine the likelihood that a person may have sleep apnea. It utilizes three main categories of simple questions to access whether an individual is at risk for sleep-disordered breathing. You may print and complete the questionnaire if you suspect you may have a sleep disorder. The directions are provided with the form and Oregon Sleep Associates can help you interpret the results.
The OSA Adolescent Sleep Questionnaire is a series of questions, similar to the adult version above, that provides Oregon Sleep Associates with information about out pediatric patients' medical histories. The form should be completed together by parents and their children.
This Insomnia Questionaire was developed to help our physicians better understand patient's difficulties with and attitudes towards sleep.