Tired of Restless Nights?
Take This 60-Second CBT-I Sleep Assessment!

Insomnia, Waking Up Tired?
CBT-I Can Help Instantly

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How long does it usually take you to fall asleep? *

Less than 15 minutes
15-30 minutes
30-60 minutes
More than an hour

Do you wake up feeling rested? *

Always
Often
Occasionally
Never

How often do you wake up during the night? *

Never
Rarely
Often
All the night

Do you use substances to help you induce sleep? (alcohol, cannabis, medication, etc.) *

Never
Occasionaly
Often
Every Night

Do you experience nocturnal (sleep) panic attacks *

Never
Rarely
Often
Always

sleep? in (Not

Would you be interested in other online therapy options? *

☑️ Interactive online seminars
☑️ Individual diagnosis & treatment via Zoomond Choice
☑️ Professionally monitored self-help CBT-I programThird Choice
☑️ Professionally monitored WhatsApp peer support group
☑️ None of them

Please supply your email adress (Not Obligatory)

Email

Confirm Email

I affirm that I have NOT been diagnosed with sleep apnea, hospitalized in a psychiatric unit, or attempted suicide in the last 5 years *

Check to affirm