Use our readymade template to create your STOP-Bang Sleep Apnea Questionnaire
Create your care assessments
| STOP-Bang score | OSA Risk |
|---|---|
| 0-2 | Low |
| 3-4 | Intermediate |
| 5-8 | High |
- Prebuilt template with STOP-Bang scoring to assess the risk of Obstructive Sleep Apnea
- 8-item questionnaire that scores each of the 8 criteria as “0” (No) to “1” (Yes)
- Real-time calculation of STOP-Bang Score based on the form responses
- Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
- Easily create responsive forms that allow patients to complete their assessments on any device at any time
Collect responses from your patients
| Patient ID | 1004 |
| Patient Name | John W |
| Patient Email | johnw@ymail.com |
| Patient Phone Number | 0987654321 |
| Doctor's Name | Dr. Smith |
| Location | New York |
| Snoring | Yes |
| Tired | No |
| Observed | Yes |
| Pressure | No |
| BMI | Yes |
| Age | Yes |
| Neck size large | No |
| Gender | Male |
| STOP-BANG Score | 5 |
| OSA Risk | High |
- Pre-populate patient details such as patient id, name, email etc in the STOP-Bang assessment form before sharing it with the patients
- Send an email invitation with a secure link for patients to complete their STOP-Bang assessment form prior to their visit
- Allow patients to save their progress and complete their STOP-Bang assessment form at a later time without losing any responses
- Set up an email template for your STOP-Bang assessment and automatically send invitation emails to multiple patients with ease
- Send a confirmation email to the patients with their STOP-Bang score, diagnosis, next steps when they submit their STOP-Bang assessment
Track patient responses in Google Sheets
| A | B | C | D | E | |
|---|---|---|---|---|---|
| 1 | Name | Question | Answer | Score | Total Score |
| 2 | John W | Snoring | Yes | 1 | 5 |
| 3 | John W | Tired | No | 0 | 5 |
| 4 | John W | Observed | Yes | 1 | 5 |
| 5 | John W | Pressure | No | 0 | 5 |
| 6 | John W | BMI | Yes | 1 | 5 |
| 7 | John W | Age | Yes | 1 | 5 |
| 8 | John W | Neck size large | No | 0 | 5 |
| 9 | John W | Gender | Male | 1 | 5 |
- Export patient responses including the calculated STOP-Bang score to Google Sheets for easy record-keeping
- Export individual points for 8 criteria to Google Sheets for data manipulation and analysis for comprehensive insights
- Use pre-built reports to easily keep track of patient progress over time and monitor changes in their sleep apnea symptoms
- Receive a copy of the response and the calculated STOP-Bang score by email whenever a patient submits their STOP-Bang assessment
- Use data in Google Sheets to integrate with external EHR systems for seamless data transfer
HIPAA compliance
| Patient ID: | 1004 |
| Patient Name: | ****** |
| Patient Email: | ****** |
| Patient Phone Number: | ****** |
| Doctor's Name: | Dr. Smith |
| Location: | New York |
| Snoring: | Yes |
| Tired: | No |
| Observed: | Yes |
| Pressure: | No |
| BMI: | Yes |
| Age: | Yes |
| Neck size large: | No |
| Gender: | Male |
| STOP-BANG Score: | 5 |
| OSA Risk: | High |
| STOP-BANG Score: | 5 |
| OSA Risk: | High |
- Create a HIPAA compliant STOP-Bang assessment form to safely collect, store and access patient responses
- Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI
- Automatically mask PHI fields when exporting STOP-Bang form responses to Google Sheets and sending them on email
- Prepopulate patient details in STOP-Bang assessments by creating secure prefill links without exposing PHI
- Limit access to patient data only for authorized personnel and minimize the risk of data breaches
These reviews are reproduced without modification from Google Workspace Marketplace.
July 27, 2023
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July 23, 2023
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February 16, 2024
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October 31, 2023
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July 12, 2023
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November 27, 2023
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July 10, 2023
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