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Home
About Us
About Sleep Medicine
Our Team
Appointments
Our Locations/Services
Medical Practice Charlestown Diagnostic
Medical Practice Charlestown Treatment
Sleep Laboratory Warners Bay
Resources
Home Sleep Test Set Up
Referrals
Contact
Warners Bay Labratory In Patient Test Evaluation
Fill in and submit the form on the below.
Date
(DD/MM/YYYY)
Test Type
Sleep Study
CPAP titration
Day Test MSLT
MWT
Split study
1. I was provided with clear instructions prior to my sleep study.
Unsatisfied
Somewhat satisfied
Satisfied
Very satisfied
Please comment
2. What was going to happen during the study was explained to me.
Unsatisfied
Somewhat satisfied
Satisfied
Very satisfied
Please comment
3. All my questions were answered to my satisfaction.
Unsatisfied
Somewhat satisfied
Satisfied
Very satisfied
Please comment
4. The staff responded and assisted me if I needed them.
Unsatisfied
Somewhat satisfied
Satisfied
Very satisfied
Please comment
5. The room was clean and comfortable.
Unsatisfied
Somewhat satisfied
Satisfied
Very satisfied
Please comment
6. The room was quiet during my sleep.
Unsatisfied
Somewhat satisfied
Satisfied
Very satisfied
Please comment
7. How CPAP works was explained to me.
Unsatisfied
Somewhat satisfied
Satisfied
Very satisfied
Noy Applicable
Please comment
8. The mask was tested on me before sleep.
Unsatisfied
Somewhat satisfied
Satisfied
Very satisfied
Noy Applicable
Please comment
9. I was provided with clear instructions upon leaving.
Unsatisfied
Somewhat satisfied
Satisfied
Very satisfied
Please comment
10. How would you rate your overall experience?
Unsatisfied
Somewhat satisfied
Satisfied
Very satisfied
Please comment
11. Would you recommend Sleep Medicine to others?
Yes
No
Please comment
We would love to hear any additional comments you have regarding your experience:
If you are happy for a staff member to call, email or write to you, regarding your valued comments please write your fill in your details below
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