David Nolte Pharmacy
Obstructive Sleep Apnoea

Please fill out the following questionnaire on sleep behaviour. The more questions you answer, the more accurate your results will be. The questionnaire should take less than 5 minutes to answer, but please take your time and accurately complete the questionnaire. Once the questionnaire is completed click the “submit” button at the bottom of the final page. If you exit the program before clicking the “submit” button no answers will be recorded or results presented. Also refrain from using the web-browser's "Back" button; if you require to return to previous questions please use the “previous” button at the bottom of the page. Use of the web-browser's "refresh" button will also clear any answers you have already entered. Information collected through this form is for the sole use of Sleepap in relation to the individual concerned and holds only such personal information as is reasonable for us to deliver services to our patients. All information received will be kept confidential in accordance with the Privacy Act 1988 of the Commonwealth of Australia.