Call: (02)80904358 9am-3pm, Mon-Fri
Home Sleep Study Booking
Consumer products
Services
Aer Centres
About Us
Talk to Us
0
Sign In
My Account
Call: (02)80904358 9am-3pm, Mon-Fri
Home Sleep Study Booking
Consumer products
Services
Aer Centres
About Us
Talk to Us
0
Sign In
My Account
Check Your Goals
Check Your Treatment Goals
We’d like some feedback on your treatment so we can help you get a better night’s rest.
Name
*
First Name
Last Name
Email
*
Why are you seeing us?
*
Tick all relevant boxes
Snoring
Sleep apnoea
Better sleep
Tired during the day
Sore muscles from tooth grinding
Solution of a jaw joint problem
Fewer bathroom visits at night
Less waking up at night
Other
If other, please specify:
What is your treatment pathway?
*
Tick all relevant boxes
Custom oral appliance
Trial oral appliance
CPAP rental
Custom CPAP mask
Positional therapy
How satisfied are you with your treatment so far?
*
Have we helped you with your treatment goals?
Very satisfied
Satisfied
Neutral
Dissatisfied
Very dissatisfied
Do you have any comments on your treatment so far?
*
Please let us know what you are happy with and what we can improve on.
Thank you!
