Please fill in the Practice Medical History Form.
Do you, or have you ever suffered from the following:
Please tick whether you have had any of the following:
When?
Results
Indicate on the following scale how severe your pain is the majority of the time
No Pain
Severe
In the last 5 Years
If you answered yes to 3 or more items, you are at increased risk of obstructive sleep apnoea. Your dentist will discuss this with you.
