Sleep Assessment

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No medical insurance? No problem! Levata Sleep has partnered with Cherry to offer flexible financial options.

Start Application Process

Start your Sleep Assessment

Do you snore?(Required)

Yes

Do you often feel tired, fatigued or sleepy during the daytime?(Required)

Yes

Has anyone observed that you stop breathing, choke or gasp while you're sleeping?(Required)

Yes

Do you have or are you being treated for high blood pressure?(Required)

Yes

Is your BMI above 24 (female) or 27 (male)?(Required)

Yes

Is your age above 50 years old?(Required)

Yes

Is your neck size larger than 15" (female) or 16.5" (male)?(Required)

Yes

Have you ever had a sleep test before?(Required)

Yes

If you answered yes above, what was the approximate date of your last sleep test?

Name(Required)

First Last

Phone(Required)

Email(Required)

Preferred Contact Time

Morning

Afternoon

If you answered "yes" to any of the above, then you are at risk for Sleep Apnea.

If you would like to submit this Assessment, our patient liaison can reach out by phone or email to review your results and discuss next steps.

This information will help us determine if you need to get a home sleep test for Sleep Apnea.

+1 (906) 242-2443
info@levatasleep.com

304 State Highway 553
Marquette, Michigan 49855

Monday – Thursday 9AM – 4PM

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