HomeLicence registrationApplication for a License to use the ESS Please complete this form to apply for a license to use the Epworth Sleepiness Scale. If your usage is deemed commercial in nature an annual license fee is applicable. Once submitted, our team will be back in touch to advise the status of application. Company name* Your name* Your email* Your position Your division Company Phone No* Direct Phone No Fax No Website Street Address Suburb State ZIP / Post Code Country Leave this section blank if same as Street Address Postal Address Suburb State ZIP / Post Code Country Study Name Study Start Date Study Scheduled End Date * indicates required field Please type characters in box below to validate form