2020- Questionnaire – Snap Diagnostics, LLC

Do I have Sleep Apnea?

The STOP-BANG Questionnaire is commonly used to screen for obstructive sleep apnea. Answer the eight questions below to assess your risk of sleep apnea.

Do you Snore Loudly (loud enough to be heard through closed doors or your bed partner elbows you for snoring at night)?

Do you often feel Tired, Fatigued, or Sleepy during the daytime (such as falling asleep
during driving)?

Has anyone Observed you Stop Breathing or Choking/Gasping during your sleep?

Do you have or are you being treated for High Blood Pressure?

Is your Body Mass Index (BMI) more than 35 ?

Are you older than 50 years of age?

Is your gender male?

Is your neck size large? For male answer "yes" if your shirt collar or neck circumference is 17" or larger. For female answer "yes" if your shirt collar or neck circumference 16" or larger.

Name provided (Optional)

email (Optional: only needed if you want an email of your result)

Any patient status updates you enter on your portal are instantly communicated to the Ordering Provider's Patient Portal.

The Master Admin can add an unlimited number of additional login accounts for their organization. Turn notifications ON to get email alerts.

You can transfer any patient to another treatment provider.
The patient will move off your portal and instantly be shown on the portal for the Treatment Provider you selected.
The Ordering Provider's Patient Portal will also instantly reflect the new Treatment Provider.

Sending a patient to Snap for an HST is as Easy as 1, 2, 3.
Select the Ordering Provider for the HST.
Enter a few patient details.
Upload the Medical Order from the Ordering Provider.

This is the information we need to setup the TX Provider Account.
Please gather all of the information shown and send to Snap personnel.