Sleep Study Quality Control Feedback Download
Quality Control Feedback Form
Recording Tech: _______________________ Scoring Tech: ________________________
Scorer’s Feedback:
Adequate acquisition baseline/treatment Yes No
Instrument calibrations completed Yes No
Bio-Calibrations completed Yes No
Artifact recognition/ intervention Yes No
Adequate CPAP titration Yes No
Patient paperwork completed Yes No
Scoring Tech Comments:_____________________________________________________
Interpreting Physician’s Feedback:
EEG Recording Quality Satisfactory Yes No
Other channel recording quality Satisfactory Yes No
Adequate treatment titration N/A Yes No
Overall quality of recording Excellent Satisfactory Marginal Poor
Scoring quality satisfactory Yes No
EKG recording/scoring satisfactory Yes No
Notes:____________
Physician signature________________ Date:___________
Board-certified sleep M.D. physicians, scientists, editors and writers for ASA.
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