Use our readymade template to create your Morningness-Eveningness Questionnaire (MEQ) for assessing circadian rhythm preferences
Create your care assessments
MEQ score | Morningness-Eveningness Category |
---|---|
70-86 | Definite morning |
59-69 | Moderate morning |
42-58 | Intermediate |
31-41 | Moderate evening |
16-30 | Definitely evening |
- Prebuilt template with MEQ scoring to assess the presence of circadian rhythm sleep disorders and measure its severity
- 19-item questionnaire that scores each item based on the individual's preference for morning or evening activities
- Real-time calculation of MEQ Score and morningness-eveningness category based on the form responses
- Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
- Compare the scores from the initial screening with that of the followup to track the progression of sleep-wake disturbances
- Easily create responsive forms that allow patients to complete their assessments on any device at any time
Collect responses from your patients
Patient ID | 1004 |
Patient Name | John W |
Patient Email | johnw@ymail.com |
Patient Phone Number | 0987654321 |
Doctor's Name | Dr. Smith |
Location | New York |
1. What time would you get up if you were entirely free to plan your day? | 7:45 – 9:45 AM |
2. What time would you go to bed if you were entirely free to plan your evening? | 10:15 PM – 12:30 AM |
3. If there is a specific time at which you have to get up in the morning, to what extent do you depend on being woken up by an alarm clock? | Fairly dependent |
4. How easy do you find it to get up in the morning (when you are not woken up unexpectedly)? | Fairly easy |
5. How alert do you feel during the first half hour after you wake up in the morning? | Fairly alert |
6. How hungry do you feel during the first half-hour after you wake up in the morning? | Fairly hungry |
7. During the first half-hour after you wake up in the morning, how tired do you feel? | Fairly refreshed |
8. If you have no commitments the next day, what time would you go to bed compared to your usual bedtime? | 1-2 hours later |
9. You have decided to engage in some physical exercise. A friend suggests that you do this for one hour twice a week and the best time for him is between 7:00 – 8:00 am. Bearing in mind nothing but your own internal “clock”, how do you think you would perform? | Would find it difficult |
10. At what time of day do you feel you become tired as a result of need for sleep? | 10:15 PM – 12:45 AM |
11. You want to be at your peak performance for a test that you know is going to be mentally exhausting and will last for two hours. You are entirely free to plan your day. Considering only your own internal “clock”, which ONE of the four testing times would you choose? | 11:00 AM – 1:00 PM |
12. If you got into bed at 11:00 PM, how tired would you be? | Fairly tired |
13. For some reason you have gone to bed several hours later than usual, but there is no need to get up at any particular time the next morning. Which ONE of the following are you most likely to do? | Will wake up at usual time but will fall asleep again |
14. One night you have to remain awake between 4:00 – 6:00 AM in order to carry out a night watch. You have no commitments the next day. Which ONE of the alternatives will suite you best? | Would take a good sleep before and nap after |
15. You have to do two hours of hard physical work. You are entirely free to plan your day and considering only your own internal “clock” which ONE of the following time would you choose? | 11:00 AM – 1:00 PM |
16. You have decided to engage in hard physical exercise. A friend suggests that you do this for one hour twice a week and the best time for him is between 10:00 – 11:00 PM. Bearing in mind nothing else but your own internal “clock” how well do you think you would perform? | Would find it difficult |
17. Suppose that you can choose your own work hours. Assume that you worked a FIVE hour day (including breaks) and that your job was interesting and paid by results). Which FIVE CONSECUTIVE HOURS would you select? | 5 hours starting between 9:00 AM and 2:00 PM |
18. At what time of the day do you think that you reach your “feeling best” peak? | 10:00 AM – 5:00 PM |
19. One hears about “morning” and “evening” types of people. Which ONE of these types do you consider yourself to be? | Rather more a “morning” than an “evening” type |
MEQ Score | 58 |
Morningness -Eveningness | Intermediate |
- Pre-populate patient details such as patient id, name, email etc in the MEQ assessment form before sharing it with the patients
- Send an email invitation with a secure link for patients to complete their MEQ assessment form prior to their visit
- Allow patients to save their progress and complete their MEQ assessment form at a later time without losing any responses
- Set up an email template for your MEQ assessment and automatically send invitation emails to multiple patients with ease
- Send a confirmation email to the patients with their MEQ score, diagnosis, next steps when they submit their MEQ assessment
Track patient responses in Google Sheets
A | B | C | D | E | |
---|---|---|---|---|---|
1 | Name | Question | Answer | Score | Total Score |
2 | John W | 1. What time would you get up if you were entirely free to plan your day? | 7:45 – 9:45 AM | 3 | 58 |
3 | John W | 2. What time would you go to bed if you were entirely free to plan your evening? | 10:15 PM – 12:30 AM | 3 | 58 |
4 | John W | 3. If there is a specific time at which you have to get up in the morning, to what extent do you depend on being woken up by an alarm clock? | Fairly dependent | 2 | 58 |
5 | John W | 4. How easy do you find it to get up in the morning (when you are not woken up unexpectedly)? | Fairly easy | 3 | 58 |
6 | John W | 5. How alert do you feel during the first half hour after you wake up in the morning? | Fairly alert | 3 | 58 |
7 | John W | 6. How hungry do you feel during the first half-hour after you wake up in the morning? | Fairly hungry | 3 | 58 |
8 | John W | 7. During the first half-hour after you wake up in the morning, how tired do you feel? | Fairly refreshed | 3 | 58 |
9 | John W | 8. If you have no commitments the next day, what time would you go to bed compared to your usual bedtime? | 1-2 hours later | 2 | 58 |
10 | John W | 9. You have decided to engage in some physical exercise. A friend suggests that you do this for one hour twice a week and the best time for him is between 7:00 – 8:00 am. Bearing in mind nothing but your own internal “clock”, how do you think you would perform? | Would find it difficult | 2 | 58 |
11 | John W | 10. At what time of day do you feel you become tired as a result of need for sleep? | 10:15 PM – 12:45 AM | 3 | 58 |
12 | John W | 11. You want to be at your peak performance for a test that you know is going to be mentally exhausting and will last for two hours. You are entirely free to plan your day. Considering only your own internal “clock”, which ONE of the four testing times would you choose? | 11:00 AM – 1:00 PM | 3 | 58 |
13 | John W | 12. If you got into bed at 11:00 PM, how tired would you be? | Fairly tired | 3 | 58 |
14 | John W | 13. For some reason you have gone to bed several hours later than usual, but there is no need to get up at any particular time the next morning. Which ONE of the following are you most likely to do? | Will wake up at usual time but will fall asleep again | 2 | 58 |
15 | John W | 14. One night you have to remain awake between 4:00 – 6:00 AM in order to carry out a night watch. You have no commitments the next day. Which ONE of the alternatives will suite you best? | Would take a good sleep before and nap after | 3 | 58 |
16 | John W | 15. You have to do two hours of hard physical work. You are entirely free to plan your day and considering only your own internal “clock” which ONE of the following time would you choose? | 11:00 AM – 1:00 PM | 3 | 58 |
17 | John W | 16. You have decided to engage in hard physical exercise. A friend suggests that you do this for one hour twice a week and the best time for him is between 10:00 – 11:00 PM. Bearing in mind nothing else but your own internal “clock” how well do you think you would perform? | Would find it difficult | 3 | 58 |
18 | John W | 17. Suppose that you can choose your own work hours. Assume that you worked a FIVE hour day (including breaks) and that your job was interesting and paid by results). Which FIVE CONSECUTIVE HOURS would you select? | 5 hours starting between 9:00 AM and 2:00 PM | 3 | 58 |
19 | John W | 18. At what time of the day do you think that you reach your “feeling best” peak? | 10:00 AM – 5:00 PM | 3 | 58 |
20 | John W | 19. One hears about “morning” and “evening” types of people. Which ONE of these types do you consider yourself to be? | Rather more a “morning” than an “evening” type | 4 | 58 |
- Export patient responses including the calculated MEQ score and morningness-eveningness category to Google Sheets for easy record-keeping
- Export individual points for each item to Google Sheets for data manipulation and analysis for comprehensive insights
- Use pre-built reports to easily keep track of patient progress over time and monitor changes in their sleep-wake preferences
- Receive a copy of the response and the calculated MEQ score by email whenever a patient submits their MEQ assessment
- Use data in Google Sheets to integrate with external EHR systems for seamless data transfer
HIPAA compliance
Patient ID: | 1004 |
Patient Name: | ****** |
Patient Email: | ****** |
Patient Phone Number: | ****** |
Doctor's Name: | Dr. Smith |
Location: | New York |
1. What time would you get up if you were entirely free to plan your day?: | 7:45 – 9:45 AM |
2. What time would you go to bed if you were entirely free to plan your evening?: | 10:15 PM – 12:30 AM |
3. If there is a specific time at which you have to get up in the morning, to what extent do you depend on being woken up by an alarm clock? : | Fairly dependent |
4. How easy do you find it to get up in the morning (when you are not woken up unexpectedly)? : | Fairly easy |
5. How alert do you feel during the first half hour after you wake up in the morning? : | Fairly alert |
6. How hungry do you feel during the first half-hour after you wake up in the morning? : | Fairly hungry |
7. During the first half-hour after you wake up in the morning, how tired do you feel? : | Fairly refreshed |
8. If you have no commitments the next day, what time would you go to bed compared to your usual bedtime? : | 1-2 hours later |
9. You have decided to engage in some physical exercise. A friend suggests that you do this for one hour twice a week and the best time for him is between 7:00 – 8:00 am. Bearing in mind nothing but your own internal “clock”, how do you think you would perform? : | Would find it difficult |
10. At what time of day do you feel you become tired as a result of need for sleep? : | 10:15 PM – 12:45 AM |
11. You want to be at your peak performance for a test that you know is going to be mentally exhausting and will last for two hours. You are entirely free to plan your day. Considering only your own internal “clock”, which ONE of the four testing times would you choose? : | 11:00 AM – 1:00 PM |
12. If you got into bed at 11:00 PM, how tired would you be? : | Fairly tired |
13. For some reason you have gone to bed several hours later than usual, but there is no need to get up at any particular time the next morning. Which ONE of the following are you most likely to do? : | Will wake up at usual time but will fall asleep again |
14. One night you have to remain awake between 4:00 – 6:00 AM in order to carry out a night watch. You have no commitments the next day. Which ONE of the alternatives will suite you best? : | Would take a good sleep before and nap after |
15. You have to do two hours of hard physical work. You are entirely free to plan your day and considering only your own internal “clock” which ONE of the following time would you choose? : | 11:00 AM – 1:00 PM |
16. You have decided to engage in hard physical exercise. A friend suggests that you do this for one hour twice a week and the best time for him is between 10:00 – 11:00 PM. Bearing in mind nothing else but your own internal “clock” how well do you think you would perform? : | Would find it difficult |
17. Suppose that you can choose your own work hours. Assume that you worked a FIVE hour day (including breaks) and that your job was interesting and paid by results). Which FIVE CONSECUTIVE HOURS would you select? : | 5 hours starting between 9:00 AM and 2:00 PM |
18. At what time of the day do you think that you reach your “feeling best” peak? : | 10:00 AM – 5:00 PM |
19. One hears about “morning” and “evening” types of people. Which ONE of these types do you consider yourself to be? : | Rather more a “morning” than an “evening” type |
MEQ Score: | 58 |
Morningness -Eveningness: | Intermediate |
MEQ Score: | 58 |
Morningness -Eveningness: | Intermediate |
- Create a HIPAA compliant MEQ assessment form to safely collect, store and access patient responses
- Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI
- Automatically mask PHI fields when exporting MEQ form responses to Google Sheets and sending them on email
- Prepopulate patient details in MEQ assessments by creating secure prefill links without exposing PHI
- Limit access to patient data only for authorized personnel and minimize the risk of data breaches
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