Referring Physician

Satisfaction Survey

Sleep Solutions takes great pride in providing you with quality testing and care. It is our hope you will be more than pleased with our services and be happy to recommend our Sleep Center to others. Please take a few minutes to answer the following questions. Please use the rating system below to rate your response.

1-Unsatisfactory2-Needs Improvement 3-Satisfactory 4-Good 5-Excellent

1. How did you learn about our Sleep Center:

2. The Sleep Study information you received before the study was adequate

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3. The scheduling experience was satisfactory and informative:

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4. Directions to the Sleep Center were accurate and easy to follow:

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5. The Sleep Center was clean and your needs were met:

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6. The Technologist explained the sleep study (hook-up) process adequately:

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7. Technologist was professional in appearance and behavior:

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8. Please rate your overall experience with our services:

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9. Likelihood of recommending our Center to anyone who needs a sleep study:

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Please feel free to comment on your experience. It is always pleasing to know a patient had a pleasant experience. However, it is more important to ascertain any problems or discomforts you may have experienced in order to improve our services.

Comments: 

Patient Name (Optional):  

    

Sleep Disorders & Test

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