BETTER SLEEP starts with testing!

Before we set up your sleep studies we will need to get to know you.

Please complete this survey to get one step closer to understanding why you are having difficulty with your sleep. This allows our Headache Center Team of Doctors to give a more personalized Better Sleep Report.

This report is unique to your sleep studies and includes recommendations to help you improve your sleep.

Let's get to know you...

First Name *

Last Name *

Cell Phone Number *

Email *

Address *

City *

State *

Postal code *

Sleep Information

Date of birth *

Gender *

Male

Female

Do you snore? *

Yes

No

Unsure

Preferred Sleeping Position. Check all that apply. *

Health Information

While this section is not required, sharing your protected health information allows us to customize your Better Sleep Report.

Height

Weight

Medications

Medical History

Additional Information

Please tell The Headache Center Team what you would like to get out of having your sleep checked.

My Sleep Goal

The Headache Center is a collection of different medical specialists focused on your health. Diagnosing a sleep problem can be complex and may need different medical specialties to make a sleep diagnosis. The Better Sleep Report utilizes a very accurate sleep study series through the SleepImage Ring with recommendations from The Headache Center Team once your sleep study series is completed. The recommendations are unique to you and your sleep studies. Information and resources will be provided to assist you with understanding your sleep studies. These recommendations are based on the results of your sleep series. Assitance and support is also available for your family physician or other medical practitioner.

We look forward to assisting you with your sleep, with the hopes that you will SLEEP BETTER.

Please answer the following question to continue your journey on understanding your sleep.

"I understand that BETTER SLEEP and The Headache Center are providing a service to give guidelines about my sleep. My BETTER SLEEP REPORT uses an FDA approved, medical sleep study device, and the recommendations given are to assist my medical team in determining a sleep diagnosis. I understand that The Headache Center is not diagnosing any sleep issue through this process."

I agree *

Yes

No

BETTER SLEEP TEAM

Meet Your Better Sleep Team

Dr. Yohanan has 30 years of experience following his residency at the Mayo Clinic. He brings his specific medical knowledge into your Better Sleep Report from the unique perspective of an Otolaryngologist. His expertise in allergies and ENT problems add value to your report.

James Yohanan MD

Dr. Brown, a physical therapist, has a second Doctorate with an emphasis on headaches. Sleep is a big part of his practice and the foundation of a physical medicine diagnosis and treatment plan. His sleep coaching background rounds out the Better Sleep Team.

Jonathan Brown DPT, DSc

Joel has over 25 years of experience in treating head, neck and face pain. He sees sleep as the foundation for all other aspects of our health. His unique background in 3D imaging of the head and neck, combined with his work as a TMJ specialist, make him an integral part of the team.

Joel Rauser PT

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Contact

connect@headachecenter.co

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