Sleep Questionnaire

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Full Name *

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Email Address *

off any you

How often do you wake during the night and find it hard to switch off again? *

How often do you wake up during the night and have trouble getting back to sleep? *

How would you rate the quality of your sleep in the past week? *

Please describe any factors you think may be contributing to your sleep difficulties. *

Do you find it hard to switch off after intense workdays or meetings? *

Are you interested in getting help to resolve these sleep problems? *

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