Menu

New Patient Forms

Download Our New Patient Forms
New Patient Form, HIPPA and Sleep Questionnaire
Tell Us About Your Sleep Issues

Restful, restorative sleep is essential to maintaining your health, and a skilled dentist can help you enjoy a good night’s sleep again. Federici Dental is your Manahawkin, NJ dentist with the experience and expertise to help you overcome troublesome—and dangerous—sleep apnea.

We have developed a few surveys to help us better understand the sleep issues you are experiencing. When our team knows more about how lack of sleep affects your day-to-day activities, we can determine how best to treat your condition. Our questionnaires focus on your:

  • Sleep habits
  • Lifestyle
  • Symptoms

Please download and complete either one of the sleep surveys posted here to get started. They contain simple checklists that are quick and easy to answer.

Download and complete one of our two sleep surveys below. 



Home Sleep Questionnaire

Easy Screener Epworth Sleepiness Scale

Visit Our Office For an Obstructive Sleep Apnea Consultation!


When you have completed a survey, contact our office for a consultation by calling 609-597-1234 or complete an online appointment request form. As a well-qualified general dentist in Manahawkin, NJ, we look forward to helping you with all your dental needs, including sleep apnea

Federici Dental

  • Federici Dental - 1301 Route 72 W. Unit 230, Manahawkin, NJ 08050 Phone: 609-597-1234 Fax: 609-597-8873

2018 © All Rights Reserved | Website Design By: West | Login