How are we doing?
Your feedback is important so we can continue to improve our patient experience.
Technicians Name: *
Choose Below
Christy
Michelle
Marvin
Cesar
Aly
Jennifer
Mindy
Maredel
Pat
Judy
Billy
Sarah
Other/Unknown
Department Visited *
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Sleep Study Setup
CPAP Setup
Other CPAP Visit
Billing
Was your appointment on time?
Yes
No
Scheduling my appointment was easy
Yes
No
The equipment I received was clean and undamaged
Yes
No
Instructions for my sleep test and/or sleep therapy were easy to understand
Yes
No
My technician was competent and showed concern for me
Yes
No
Are there any departments that you feel need improvement?
None
Reception
Respiratory
Diagnostics
Resupply
Billing
On a scale of zero to ten, how likely are you to recommend our business to a friend or colleague?
0
1
2
3
4
5
6
7
8
9
10
Additional Comments
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