AWAKE Peer Mentees eligibility Please fill in the form below so we can match you with the perfect Peer Mentor. Name * Name First First Last Last Email * Phone Gender * Male Female Transgender Male Transgender Female Fluid Questioning or Unsure Prefer Not To Answer Year of Birth * Your Time Zone Eastern US Central US Mountain US Pacific US Hawaii/Alutian Alaska Daylight Time Outside of the US Zip Code * How many hours per night do you use your machine for treatment? 0-3 hours 4-6 hours 7 or more hours How many nights a week do you use your machine for treatment? 0-2 nights 3-5 nights 6 or more nights Which CPAP machine are you currently using? PM_starting_date Submit Δ
