Patient Forms

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.

Insomnia Questionaire

This Insomnia Questionaire was developed to help our physicians better understand patient's difficulties with and attitudes towards sleep.

Download PDF Form

Other Sleep Related Forms

Berlin Sleep Questionnaire

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.

Download PDF Form

 

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.

Download PDF Form