This screening helps your provider understand your sleep and jaw health. All information is confidential and assists in determining whether the bioSense™ wellness platform may benefit you.
Patient Information
Section 1 — Sleep Quality
1. How would you rate your overall sleep quality?
Excellent
Good
Fair
Poor
Very Poor
2. How many hours of sleep do you average per night?
Less than 5
5–6 hours
6–7 hours
7–8 hours
8+ hours
3. How often do you wake up feeling unrefreshed, even after adequate sleep?
Never
Rarely
Sometimes (1–2x/week)
Often (3–5x/week)
Almost always
4. Do you or does your partner notice any of the following? (Check all that apply)
Snoring
Gasping or choking during sleep
Teeth grinding sounds
Restless or thrashing sleep
Breathing pauses during sleep
Excessive movement
Mouth breathing during sleep
None of the above
Section 2 — Jaw, Head & Facial Pain
5. Do you experience jaw pain, jaw stiffness, or jaw fatigue? YesNo
6. Do you wake with headaches, particularly at the temples or behind the eyes? YesNo
7. Do you have neck or shoulder pain that may be related to jaw tension? YesNo
8. Do you clench your teeth during the day (at work, while driving, under stress)? YesNo
9. Rate your average jaw discomfort upon waking (0 = none, 10 = severe):
None
0
1
2
3
4
5
6
7
8
9
10
Severe
Section 3 — General Health & Stress
10. How would you rate your current stress level?
Very low
Low
Moderate
High
Very high / overwhelming
11. Have you been diagnosed with any of the following? (Check all that apply)
Sleep apnea (OSA)
TMJ disorder
Anxiety disorder
Hypertension
Diabetes
Thyroid condition
Chronic fatigue
Depression
None diagnosed
12. Do you currently wear or have you previously worn a night guard or oral appliance? Yes — currently wearingYes — previously wornNo
13. Do you currently use any wearable health device (fitness tracker, smartwatch)? YesNo
If yes, which device:
14. Is there anything specific you hope to learn about your health from wearing the bioSense™?
byteSense Patient Screening Form · For practice use · Retain in patient chart · bytesense.ai
CASE SUBMISSION CHECKLIST
Complete Before Every Case Submission
File in Patient Chart with Consent Form
Case Submission Checklist & Quality Control Form
Every case submitted to Florida Oral Labs must pass this checklist. Incomplete submissions result in delays. This form travels with the case — keep a copy in the patient's chart.
Patient & Case Information
Stage 1 — Pre-Scan Patient Compliance
Patient consent form signed — original filed in patient chart, copy retained in byteSense practice records
Patient eligibility confirmed — all mandatory inclusion criteria reviewed and documented
Mandatory criteria verified: Arch perimeter >123mm · No irregular eruptions · Min 1.7mm occlusal clearance · Flat plane splint compatible
Patient has received the bioSense™ Patient Welcome Guide — and knows app setup steps
Payment collected — before or at time of scan. Practice lab fee payment arranged with Florida Oral Labs.
Delivery appointment pre-scheduled — approximately 3 weeks from today
Stage 2 — Scan Quality Checklist
Critical — Rejected Scans Cannot Be Submitted
Every item below must be confirmed before uploading to Medit. A scan that does not meet criteria will be rejected by Florida Oral Labs, requiring a new scan appointment and delaying patient delivery by up to 14 business days.
Required Files
Upper arch STL exported and uploaded to Medit order
Lower arch STL exported and uploaded to Medit order
Bite registration STL (strongly recommended — include if possible)
Scans submitted in correct bite orientation
Quality Standards — All Must Pass
No holes, gaps, or scan artifacts anywhere in the arch
Minimum 5mm gum tissue captured above every tooth
Total height (gum + tooth) ≥11mm for every tooth
All teeth fully captured — clear gum line visible
No soft tissue or cheek artifacts obscuring teeth
Full arch captured — no missing posterior segments
Stage 3 — Medit Submission Confirmation
Florida Oral Labs confirmed as active Medit partner before submission (one-time setup)
All STL files attached to Medit case order
Patient information accurate in Medit order (name, DOB, arch)
Order submitted and confirmation number noted below
Lab fee payment confirmed with Florida Oral Labs
Expected Turnaround
Florida Oral Labs fabrication time: 10–14 business days from case submission. Delivery appointment should be pre-scheduled at approximately 3 weeks from scan date. Patient should be notified when device arrives at the practice.
byteSense Case Submission Checklist · File in patient chart with signed consent form · bytesense.ai · Natasha Blake 909-527-9602
PATIENT PROGRESS TRACKER
Monthly Monitoring Form — byteSense™
Retain in Patient Chart
Patient Health Progress Monitoring Record
This form tracks patient-reported wellness outcomes and bioSense™ data trends at delivery, 2-week, 1-month, and 3-month intervals. Use to monitor device compliance, identify concerns, and document progress.
