Beluga Portal

Simon Svenman

Male · 9/25/1988 (36y) · NC menuDots

Phone: 9198976992

All Visits (1)

ApneaAsync

Master Id: 003TN00000O3BPLYA3-003TN00000O3BPLYA3-1

Active

Current Visit

Created on: 3-26-2025

Updated on: 3-26-2025

daybreak ApneaAsync

Active Visit

Master Id: 003TN00000O3BPLYA3-003TN00000O3BPLYA3-1

Consents for telemedicine and privacy policy signed?	true
First Name	Simon
Last Name	Svenman
Date of Birth	09/25/1988
Phone Number	9198976992
Email	simon.svenman@gmail.com
Address	700 Corporate Center Drive Apt. 461
City	Raleigh
State	NC
Zip	27607
Sex	Male
Self-reported Meds	N/A
Allergies	N/A
Medical Conditions	N/A
Do you snore loudly? a) Very seldom b) Yes, and it bothers me or my partner c) Yes, it wakes me up sometimes d) Often. I wake up multiple times a night	Often. I wake up multiple times a night
Do you ever stop breathing, gasp, or choke while sleeping? a) Yes b) No c) I'm not sure	Yes
Have you ever been diagnosed with Sleep Apnea? a) No b) Yes	Yes
Select any of the following options that apply to you: a) Ischemic Heart Disease b) Hypertension/high blood pressure c) Insomnia d) Mood disorder e) None of the above f) History of stroke	None of the above
Your chances of dozing off while sitting & reading: a) No chance of dozing b) Slight chance of dozing c) Moderate chance of dozing d) High chance of dozing	Moderate chance of dozing
Your chances of dozing off while watching TV: a) No chance of dozing b) Slight chance of dozing c) Moderate chance of dozing d) High chance of dozing	Moderate chance of dozing
Your chances of dozing off while sitting inactive in a public place (e.g. a theater or meeting): a) No chance of dozing b) Slight chance of dozing c) Moderate chance of dozing d) High chance of dozing	Slight chance of dozing
Your chances of dozing off while as a passenger in a car for an hour without a break: a) No chance of dozing b) Slight chance of dozing c) Moderate chance of dozing d) High chance of dozing	High chance of dozing
Your chances of dozing off while lying down to rest in the afternoon when circumstances permit: a) No chance of dozing b) Slight chance of dozing c) Moderate chance of dozing d) High chance of dozing	High chance of dozing
Your chances of dozing off while sitting and talking to someone: a) No chance of dozing b) Slight chance of dozing c) Moderate chance of dozing d) High chance of dozing	Slight chance of dozing
Your chances of dozing off while sitting quietly after a lunch without alcohol: a) No chance of dozing b) Slight chance of dozing c) Moderate chance of dozing d) High chance of dozing	High chance of dozing
Your chances of dozing off while in a car, while stopped for a few minutes in traffic: a) No chance of dozing b) Slight chance of dozing c) Moderate chance of dozing d) High chance of dozing	Slight chance of dozing
Do you currently or have you ever used CPAP? a) No, I have not used CPAP b) Yes, I have used CPAP	No, I have not used CPAP
Please select any options that apply for the following statement: I have not attempted to use a CPAP device to manage my sleep-related breathing disorder and am refusing to attempt for the following reason(s): a) Latex allergy b) Claustrophobia c) The mask/device/headgear will cause me discomfort or restrict my movement during sleep d) The noise from the device will disturb me and/or my bed partner’s sleep e) None – I am willing to try CPAP f) Other (please describe) g) Concern of pressure on upper lip causing tooth-related problems	Claustrophobia The mask/device/headgear will cause me discomfort or restrict my movement during sleep The noise from the device will disturb me and/or my bed partner’s sleep
Are you able to breathe through your nose? a) No b) Yes	Yes
Do you have any dental work that is loose or wobbly? a) No b) Yes	No
Are you allergic to vinyl polysiloxane (silicone)? a) No b) Yes	No
Do you have any questions for your physician about Sleep Apnea testing and treatment? (free text)	N/A

Assessment & Plan (Internal Note)

Patient has been educated on the treatment plan including instructions for use, risks/benefits/side effects.
No contraindications, red flags, or dangerous polypharmacy interactions identified.
If any side effects occur they should discontinue use and contact me for further instruction, except in the case of severe side effects in which case they should seek urgent care in an emergency room.
FOLLOW UP: The patient has been provided information on how to contact our medical team to follow up if any medical concerns or reactions to treatment arise at any time.
The patient is recommended to follow up with myself or the support team if additional concerns arise or the treatment plan needs to be adjusted.
Patient has been educated that there are limitations to telemedicine care, and in-person care may be necessary in certain situations (ER if severe side effects develop or through an in-person physician if signs/symptoms develop that warrant additional work up/evaluation/alternative treatments).
To the extent that I have been made aware by the company with which I contract to provide medical services,
the patient has signed relevant attestations prior to being assigned to me as a clinician that state that the patient is aware of any limitations in a virtual health encounter and understands that urgent or emergent care must be pursued in person.
I have confirmed the patient's identity via review of a legally recognized form of ID or through a second party identity verification service.
Please see doctor/patient messaging thread for any relevant dialogue which, in addition to providing supplemental medical information as needed, secures and meets the legally-defined doctor-patient relationship.
Telemedicine is appropriate for this patient encounter because it can meet the same standard of care for this patient's chief complaint and can improve access to care which remains limited in many parts of the United States.