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Patient Forms

At Sleep Associates of Connecticut, we understand that our patients lead busy lives. We want to make your experience with us as easy and convenient as possible.

You can save time by downloading,  printing and completing the following forms before our appointment.

Click on the Download PDF button for the form of your choice.
The document will open in a new browser window
Right click to save the document to your computer, where you may print it.

Patient Forms and Packets

Download PDFPatient Instructions for Sleep Study
Download PDFWeekly Sleep Log
Download PDF Patient's Sleep History Questionnaire & ESS
Download PDF Sleep Medicine Referral Form
Download PDF Patient Registration Form
Download PDF Release of Records Request
Download PDF Sleep Study Authorization Release

Formularios en Español

Download PDFInstrucciones del paciente para el estudio del sueño
Download PDF Autorización para el Estudio del Sueño

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 before coming to our clinic.

Download PDF