Laser Treatment for Snoring and Sleep Apnea

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* 1. Snoring ?
Do you Snore Loudly (loud enough to be heard through closed doors or your bed-partner elbows you for snoring at night)?

Yes

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* 2. Tired ?
Do you often feel Tired, Fatigued, or Sleepy during the daytime (such as falling asleep during driving or talking to someone)?

Yes

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* 3. Observed?
Has anyone Observed you Stop Breathing or Choking/Gasping during your sleep?

Yes

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* 4. Pressure?
Do you have or are being treated for High Blood Pressure?

Yes

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* 5. Body Mass Index more than 35 kg/m2?
You can calculate it here

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* 6. Age older than 50?

Yes

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* 7. Is neck size larger than:
For male, is your shirt collar 17 inches / 43cm or larger?
For female, is your shirt collar 16 inches / 41cm or larger?

Yes

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* 8. Gender = Male?

Yes

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* 9. Please fill in your contact information to receive the $100 discount on your first Treatment

First name *

Last name

Email Address *

Phone Number *

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* 10. How would you like us to contact you?

Phone call

text message

Question Title

* 1. Snoring ?Do you Snore Loudly (loud enough to be heard through closed doors or your bed-partner elbows you for snoring at night)?

Question Title

* 2. Tired ?Do you often feel Tired, Fatigued, or Sleepy during the daytime (such as falling asleep during driving or talking to someone)?

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* 3. Observed?Has anyone Observed you Stop Breathing or Choking/Gasping during your sleep?

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* 4. Pressure?Do you have or are being treated for High Blood Pressure?

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* 5. Body Mass Index more than 35 kg/m2?You can calculate it here

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* 6. Age older than 50?

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* 7. Is neck size larger than: For male, is your shirt collar 17 inches / 43cm or larger?For female, is your shirt collar 16 inches / 41cm or larger?

Question Title

* 8. Gender = Male?

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* 9. Please fill in your contact information to receive the $100 discount on your first Treatment

Question Title

* 10. How would you like us to contact you?

* 1. Snoring ?
Do you Snore Loudly (loud enough to be heard through closed doors or your bed-partner elbows you for snoring at night)?

* 2. Tired ?
Do you often feel Tired, Fatigued, or Sleepy during the daytime (such as falling asleep during driving or talking to someone)?

* 3. Observed?
Has anyone Observed you Stop Breathing or Choking/Gasping during your sleep?

* 4. Pressure?
Do you have or are being treated for High Blood Pressure?

* 5. Body Mass Index more than 35 kg/m2?
You can calculate it here

* 7. Is neck size larger than:
For male, is your shirt collar 17 inches / 43cm or larger?
For female, is your shirt collar 16 inches / 41cm or larger?