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Patient Name: Wastage: FirstMedical Record# M.I. Date of Birth: Sex:MF (circle)PHYSICIAN INFORMATION Primary Care Physician: Specialty: Address: Phone: Referring Physician: Fax: Specialty: Address:
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It is a document used to assess an individual's sleep patterns and quality of sleep after revisions have been made to the original questionnaire.
Individuals who have previously filled out the original sleep questionnaire and are asked to complete a revised version are required to file it.
Revised sleep questionnaires can typically be filled out online or on a physical form provided by the organization requesting the information. It is important to answer all questions accurately and honestly.
The purpose of the revised sleep questionnaire is to gather updated information on an individual's sleep patterns and quality of sleep, often to track changes over time or in response to interventions.
Revised sleep questionnaires may ask for information such as bedtime routine, hours of sleep per night, sleep disturbances, and overall perceived quality of sleep.
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