Digital OSA50 questionnaire

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Form template

Digital OSA50 questionnaire

Send the OSA50 questionnaire digitally to your patients. With Coflow, they answer on their phone or computer before their appointment, with no app and no login.

The total is scored the moment they submit and banded low or high risk. The score is waiting for you on the task, and responses write back to your practice management system.

Send it digitally See template

Stored in Australia

No patient app or login

Scored automatically

Writes back to your PMS

Try the digital OSA50 questionnaire

Coflow forms are flexible and mobile responsive. Patients fill it in on any phone or computer, with no app and no login. Scored forms are scored automatically when the patient submits.

osa50.pdfPage 1 of 2

OSA50 questionnaire

Obstructive sleep apnoea screening

NameDate

Please answer yes or no to each of the following questions.

1Is your waist circumference more than 102 cm (men) or 88 cm (women)? Measure at the level of your navel.

3Yes0No

2Has your snoring ever bothered other people?

3Yes0No

3Has anyone noticed that you stop breathing during your sleep?

2Yes0No

4Are you aged 50 years or over?

2Yes0No

Chai-Coetzer, C.L. et al. (2011). Primary care vs specialist sleep center management of obstructive sleep apnea. Thorax, 66(3), 213-219.Page 1 of 2

Scoring the OSA50

For the practitioner. Detach before handing the questionnaire to a patient.

How to score it

Each answer scores the number printed beside it.
Add up items 1–4. The score runs from 0 to 10.
Find the score’s band in the table further down.
If any question is unanswered, don’t score the form.

Score

Scale	How	Range	Score	Band
Obstructive sleep apnoea risk	Add up items 1–4	0–10

Bands

Obstructive sleep apnoea risk	Score
Low risk	0–4
High risk	5–10

OSA50 is a screening score, not a diagnosis. A score of 5 or more reads as high risk of moderate to severe obstructive sleep apnoea: read it alongside your own clinical assessment.

Chai-Coetzer, C.L. et al. (2011). Primary care vs specialist sleep center management of obstructive sleep apnea. Thorax, 66(3), 213-219.Page 2 of 2

OSA50

Preview only. Nothing you choose is saved or sent.

OSA50

Please answer yes or no to each of the following questions.

Is your waist circumference more than 102 cm (men) or 88 cm (women)? Measure at the level of your navel.

YesNo

Has your snoring ever bothered other people?

YesNo

Has anyone noticed that you stop breathing during your sleep?

YesNo

Are you aged 50 years or over?

YesNo

Send the OSA50 digitally

Patients answer on their phone or computer before they arrive, with no app or login. Coflow sends a reminder if they don’t finish, scores it the moment they submit, and files it into your PMS.

Scored automatically
Automatic reminders
Writes back to your PMS

Book a demo

We’ll show you the OSA50 in Coflow and set it up with you.

Please note, you may need to hold appropriate licences to use some forms in Coflow.

Writes back to

and more: Nookal and Cliniko

Learn more

Ready to send your forms digitally?

Book a demo and we’ll show you how Coflow sends forms by SMS or email, collects e-signatures and files answers into your practice management software.

Book a demo

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Digital OSA50 questionnaire

Digital OSA50 questionnaire

Try the digital OSA50 questionnaire

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