• ENT Sleep & Snoring Intake

    Please fill out with the patient's information
    ENT Sleep & Snoring Intake
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    Pick a Date
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  • How likely are you to doze off and fall asleep in the following situations? Even if you have not done some of these things recently, try to remember how you have reacted in the past. Check the most appropriate response for each situation.

    Situation:

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  • Should be Empty: