Epworth Sleepiness Scale How likely are you to doze off or fall asleep in the following situations? Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *How much do you weigh? *lbs.How tall are you? *How old are you? *Sitting and Reading: *select...0 - No Chance of Dozing1 - Slight Chance of Dozing2 - Moderate Chance of Dozing3 - High Chance of DozingWatching TV: *select...0 - No Chance of Dozing1 - Slight Chance of Dozing2 - Moderate Chance of Dozing3 - High Chance of DozingSitting Inactive in a Public Place (e.g. a theater or a meeting): *select...0 - No Chance of Dozing1 - Slight Chance of Dozing2 - Moderate Chance of Dozing3 - High Chance of DozingAs a Passenger in a Car for an Hour Without a Break: *select...0 - No Chance of Dozing1 - Slight Chance of Dozing2 - Moderate Chance of Dozing3 - High Chance of DozingLying Down to Rest in the Afternoon when Circumstances Permit: *select...0 - No Chance of Dozing1 - Slight Chance of Dozing2 - Moderate Chance of Dozing3 - High Chance of DozingSitting and Talking to Someone: *select...0 - No Chance of Dozing1 - Slight Chance of Dozing2 - Moderate Chance of Dozing3 - High Chance of DozingSitting Quietly after a Lunch without Alcohol: *select...0 - No Chance of Dozing1 - Slight Chance of Dozing2 - Moderate Chance of Dozing3 - High Chance of DozingIn a Car, while Stopped for a few Minutes in Traffic: *select...0 - No Chance of Dozing1 - Slight Chance of Dozing2 - Moderate Chance of Dozing3 - High Chance of DozingCommentSubmit
