Please complete the form below and click “Submit” to send it to us. We will be in touch with you shortly. If you would prefer to download the form in PDF format and send it to us, please CLICK HERE to do so. Thank you.
The Insomnia Severity Index has seven questions. The seven answers are added up to get a total score. Please use the scale that follows the questions to determine your score.[sws_divider_line]
Please rate the CURRENT (LAST 2 WEEKS) SEVERITY of your insomnia problem.
Use the information at the bottom of the form to determine your score.