Request Form
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Terms *

The Sleep Health Index® is a US registered trademark of the National Sleep Foundation, a 501(c)3 non-profit organization. Copyright © 2017 National Sleep Foundation. All rights reserved. No part of the Sleep Health Index® covered by the copyrights herein may be reproduced or transmitted in any form or by any means without permission of the copyright holder. Permission to use the Sleep Health Index® is granted by the National Sleep Foundation to individuals and organizations via a license agreement. Use of the Sleep Health Index® must acknowledge the National Sleep Foundation’s proprietary rights in the Sleep Health Index®, must include proper citation of the National Sleep Foundation and the associated manuscript/publication, and must include all trademark and copyright notices on all copies of the Sleep Health Index® and all of its outputs. The Sleep Health Index® does not provide medical advice and is not intended as a means for patient diagnosis. It is not a substitute for professional medical advice, diagnosis or treatment. The Sleep Health Index® is intended for informational purposes only. The National Sleep Foundation specifically disclaims any liability and does not warrant or guarantee the accuracy or completeness of the information in the Sleep Health Index® for purposes that differ from those described in the original publication: Suggested Citations:Inline: (National Sleep Foundation et al., 2017)Bibliography: The National Sleep Foundation’s Sleep Health Index. Sleep Heal. 2017;3(4):234-240. doi:10.1016/j.sleh.2017.05.011.
The Sleep Health Index® is a US registered trademark of the National Sleep Foundation, a 501(c)3 non-profit organization. Copyright © 2017 National Sleep Foundation. All rights reserved. No part of the Sleep Health Index® covered by the copyrights herein may be reproduced or transmitted in any form or by any means without permission of the copyright holder. Permission to use the Sleep Health Index® is granted by the National Sleep Foundation to individuals and organizations via a license agreement. Use of the Sleep Health Index® must acknowledge the National Sleep Foundation’s proprietary rights in the Sleep Health Index®, must include proper citation of the National Sleep Foundation and the associated manuscript/publication, and must include all trademark and copyright notices on all copies of the Sleep Health Index® and all of its outputs. The Sleep Health Index® does not provide medical advice and is not intended as a means for patient diagnosis. It is not a substitute for professional medical advice, diagnosis or treatment. The Sleep Health Index® is intended for informational purposes only. The National Sleep Foundation specifically disclaims any liability and does not warrant or guarantee the accuracy or completeness of the information in the Sleep Health Index® for purposes that differ from those described in the original publication: Suggested Citations:Inline: (National Sleep Foundation et al., 2017)Bibliography: The National Sleep Foundation’s Sleep Health Index. Sleep Heal. 2017;3(4):234-240. doi:10.1016/j.sleh.2017.05.011.
     
 
Role *

Please identify your role in the intended project

 
Name *

Please provide your full name (including prefix and/or suffix)
 
Title *

Please indicate your official title (e.g. Director, Manager, Student, etc.)
 
Contact Information

Please provide the specified contact information
 
Phone Number *

 
Affiliation

Please provide the following information regarding your organization
 
What is the name of your organization? *

 
What is the full address of your organization? *

Please include street address, city, state, and zip code
 
What type of organization is this? *


 
Proposed Study Information *

Please provide information on the purpose of your study, its objectives, and how you intend to use the Sleep Health Index
 
What is the estimated sample size you intend to enroll in your study? *


 
IRB Submission and Status

Please select the appropriate responses to the questions that follow
 
Have you submitted your study for IRB review? *

     
 
What is the status of your IRB submission? *


 
The National Sleep Foundation may be interested in the findings from your study about the Sleep Health Index®.  Would you be willing to share the data generated from your study with the National Sleep Foundation?

*

Note: The National Sleep Foundation respects all HIPAA compliance standards and is solely interested in obtaining de-identified subject study data.  Such data will be added to a growing sleep health-related database for the advancement of the field and its knowledge base.
     
 
By submitting this form you agree to the terms of the National Sleep Foundation's Sleep Health Index®. A license agreement will be constructed based on your responses in this request form outlining conditions including publication acknowledgement language and fees or fee waivers.
A representative from the National Sleep Foundation will reach out to you within 3 weeks of your submission of this request. Thank you. *


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