(NOTE: This site will be re-launching soon.)
< Return to Full Web Site


SleepMed Inc. - mySleepMed for Physicians - Physician Service Survey




Physician Name: *
  
Title: *
  
Speciality: *
  
Practice Name: *
  
Address: *
  
City: *
  
State: *
  
Zip: *
  
Phone: *
  
Email: *
  
Which service are you rating?: *
  
How would you rate the overall quality of the service we provide?: *
  
Explanation (if above is rated "Poor"):  
  
How would you rate the performance of our scheduling personnel in meeting your needs?: *
  
Explanation (if above is rated "Poor"):  
  
How would you rate the performance of our technologist/therapist personnel in providing patient care services?: *
  
Explanation (if above is rated "Poor"):  
  
How would you rate the performance of our insurance verification and accounting personnel?: *
  
Explanation (if above is rated "Poor"):  
  
How would you rate the performance of the Medical Sales Representative for your account in building awareness and referrals to your service, while assisting you with your sales and marketing needs?: *
  
Explanation (if above is rated "Poor"):  
  
How would you rate the performance of our management and leadership involved in your account in responding to your special requests in a timely and professional manner?: *
  
Explanation (if above is rated "Poor"):  
  
Would you recommend our service to others?: *
  
Explanation (if above is rated "Poor"):  
  
What can we do to improve our service to you?:  
  
Would you like to provide a testimonial that may be used in our marketing efforts?: *
  
Testimonial:  
  
 
  * indicates required information

First Name: (you must leave this field blank)
Last Name: (you must leave this field blank)
  


© 2017 SleepMed, Inc. All Rights Reserved