Ask Your Doctor Do your or a loved one feel tired or sleepy when you need to be awake?
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First Name
Last Name
Email
Do you or a loved one feel tired or sleepy when you need to be awake because of:
A non-traditional work schedule /Shift Work Disorder
Obstructive Sleep Apnea, which is treated with a breathing device
Narcolepsy (sudden uncontrollable urge to sleep)
None of the above
Are you or your loved one currently taking any of the following medications (Please select all that Apply.)
Nuvigil® (armodafinil)
Provigil® (modafinil)
Lunesta® (eszopicolne)
Ambien ® (zolpidem)
Other Prescription Sleep Aid
None of the above
Would you like to receive a FREE email series from QualityHealth with important information to help manage your condition?
Yes
No
Do you have a doctor appointment scheduled in the next 30 days to discuss this condition?
