Search

Morningness-Eveningness Questionnaire
22 reviews
25K+
Installs

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
  • navigate_next Prebuilt template with MEQ scoring to assess the presence of circadian rhythm sleep disorders and measure its severity
  • navigate_next 19-item questionnaire that scores each item based on the individual's preference for morning or evening activities
  • navigate_next Real-time calculation of MEQ Score and morningness-eveningness category based on the form responses
  • navigate_next Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
  • navigate_next Compare the scores from the initial screening with that of the followup to track the progression of sleep-wake disturbances
  • navigate_next 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
  • navigate_next Pre-populate patient details such as patient id, name, email etc in the MEQ assessment form before sharing it with the patients
  • navigate_next Send an email invitation with a secure link for patients to complete their MEQ assessment form prior to their visit
  • navigate_next Allow patients to save their progress and complete their MEQ assessment form at a later time without losing any responses
  • navigate_next Set up an email template for your MEQ assessment and automatically send invitation emails to multiple patients with ease
  • navigate_next 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
  • navigate_next Export patient responses including the calculated MEQ score and morningness-eveningness category to Google Sheets for easy record-keeping
  • navigate_next Export individual points for each item to Google Sheets for data manipulation and analysis for comprehensive insights
  • navigate_next Use pre-built reports to easily keep track of patient progress over time and monitor changes in their sleep-wake preferences
  • navigate_next Receive a copy of the response and the calculated MEQ score by email whenever a patient submits their MEQ assessment
  • navigate_next 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
  • navigate_next Create a HIPAA compliant MEQ assessment form to safely collect, store and access patient responses
  • navigate_next Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI
  • navigate_next Automatically mask PHI fields when exporting MEQ form responses to Google Sheets and sending them on email
  • navigate_next Prepopulate patient details in MEQ assessments by creating secure prefill links without exposing PHI
  • navigate_next Limit access to patient data only for authorized personnel and minimize the risk of data breaches

These reviews are reproduced without modification from Google Workspace Marketplace.

July 27, 2023

5 stars

I am 100% a fan of this company. We use HIPAA compliant Google Forms and needed a way to collect signatures, the industry standard company is TOO expensive. I started using FormEsign and it worked perfectly. It lacked the ability to provide a pdf copy of the form after signature. This company worked with me help their product evolve into something that could benefit all future clients AND the end user. The team was polite, professional, kind, enthusiastic, and willing to make a change. This earned my loyalty. I will sing their praises. Good work, and thank you!

— Royal Bush

July 23, 2023

5 stars

I am not tech savvy. I chose formesign to help create registration links for clients. Vipid has been great in assisting me. He goes above and beyond. My company now has moved from the stone age to modern age through the ability to use this feature. Of the many features I am impressed with, the ability to update a form without needing to regenerate a link is amazing. I often make mistakes and that ability allows me to fix mistakes without needing to change everything. Thank you!!!

— Sol Evans

February 16, 2024

1 stars

Does not work

— Myles Sicuro

October 31, 2023

5 stars

We needed a way to create forms with e-signatures and this app made it very easy. Support is also very quick and always helpful. Cannot recommend enough!

— Chris Henesy

July 12, 2023

5 stars

It very friendly to used. I love it. For my case multiple signature needed. it's supporting

— Senthil Kumar

November 27, 2023

5 stars

Yeah this is good for all

— luqman khan

July 10, 2023

5 stars

We were looking for a way to have a signature option in our form. Formesign addon allowed us to collect signatures for the acknowledgment and consent forms. It was simple and easy to setup. Very useful addon for google forms.

— Joan S

More...

Tags

Circadian rhythm Care assessments
close