Lake Forest Sleep Apnea Dental Devices | Lake Forest dental care | CA | Health Questionnaire

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west_logo2.pngScott E. West D.D.S., F.A.G.D., Inc.
Alternative Treatment of Snoring, Sleep Apnea and CPAP Intolerance,
Diplomate of the Academy of Clinical Sleep Disorders Disciplines
22672 Lambert St. Suite 603 •  Lake Forest, CA 92630

949 829-6700

Health Questionnaire

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Basic Health Information

In order for us to help you in an efficient and effective manner, we need to know more about the condition of your health and the current state of your snoring and/or sleep apnea.

Please download, print and complete this health and snoring questionnaire (link below) and bring it to our office on your next visit. If you have any questions about the form please call our office so we can help you complete it.

Please note that there are multiple places throughout the form that request your signature. This is necessary because we separate this form into sub-sections for various office and insurance reasons.

Download Health Form

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Please do not submit any Protected Health Information (PHI).