UT Berlin Questionnaire

The Berlin Questionnaire obtains information about risk factors for sleep apnea: snoring, sleepiness or fatigue, and the presence of obesity or hypertension. This can be used to identify patients with sleep apnea.

Please enter the following informtation:

First Name

Last Name

Title

Company Name

Street Address

Apt/Suite/Office

City

Zip Code

Country

Email Address [If you want the results sent to you, please include your email address]

Home Phone Number

Fax Number

Cell Phone Number

URL

UT Berlin Questionnaire

Berlin Sleep Questionnaire