Follow us on
Request an Appointment
Physician Referral

Patient Forms

Gingras Sleep Medicine

Thank you for selecting Gingras Sleep Medicine for infant, pediatric, and adult sleep disorder evaluation and sleep medicine treatment. To make an appointment at our Concord or Charlotte, North Carolina sleep medicine offices, please call (704) 944-0562 or request an appointment online.

Once you have made your initial appointment, you may pre-register online by completing the interactive forms below, or you may download and print the forms, fill them out, and bring them with you to your first visit. Completing the forms prior to your visit will help speed up the new patient registration process.

Please download the sleep questionnaire to your printer, fill it out completely, and bring the completed sleep questionnaire to your office visit. This questionnaire needs to be filled out before your scheduled appointment or you will need to be worked in or rescheduled. 

If you cannot print the questionnaire to a computer and fill it out before coming the office, please plan on being at the clinic 45 minutes BEFORE your scheduled appointment to complete the sleep questionnaire.

If you or your child is being evaluated for insomnia (difficulty falling and staying asleep), please print out the sleep diary and complete it for at least 2 weeks before your visit.



Please note: It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.

Get Adobe Reader