Insomnia Assessment

NOTE: This questionnaire is for informational purposes only and is not intended to function as a psychological or psychiatric assessment. Diagnosis of psychiatric disorders requires a careful evaluation by a trained professional.

The insomnia Severity Index has seven questions. The seven answers are added up to get a total score. When you have your total score, look at the Guidelines for Scoring/Interpretation below to see where your sleep difficulty fits.

For each question, please select the number that best describes your answer keeping in mind that “0” equals NONE and “4” equals VERY SEVERE.

Please rate the CURRENT (i.e. Last two weeks) of your insomnia problems.

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Selected Value: 0
0 = None and 5 = Very Severe
Selected Value: 0
0 = None and 5 = Very Severe
Selected Value: 0
0 = None and 5 = Very Severe
Selected Value: 0
0 = Very Satisfied and 5 = Very Dissatisfied
Selected Value: 0
0 = Not Noticeable and 5 = Very Noticeable
Selected Value: 0
0 = Not Worried and 5 = Very Worried
Selected Value: 0
0 = Don't Interfere and 5 = Interfere a lot

Guidelines for Scoring/Interpretation

Add the scores for all seven items (questions 1, 2, 3, 4, 5, 6, 7) = Your Total Score

Total score categories:

0-7 = No clinically significant insomnia

8-14 = Subthreshold insomnia

15-21 = Clinical insomnia (moderate severity)

22-28 = Clinical insomnia (severe)

If your results indicate you may be suffering from insomnia, please click the button to submit your forms and get started on your healing journey with medical marijuana. Our goal is to ensure all in Louisiana who could benefit from medical marijuana are given an opportunity to be guided by our compassionate staff and physicians and your medical marijuana dispensary to the best options for your treatment. 

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