Online Patient Questionnaires

Modus Five Customer

For Sleep Clinic and Sleep Dentist

Modus Five developed a set of Online Patient Questionnaires for your clinic or hospital web site.

Existing forms include: Depression Questionnaire, Medical History, Bed Partner Questionnaire, and Sleep Apnea Probability. All questionnaires can be easily customized to fit your needs and results are sent to the doctor's email and can also be saved to be analyzed later. Arithmetic and logic online calculations allow you to get scores and graphs with the answers.

Advantages of Online Patient Questionnaire:

Faster - Time to complete an online questionnaire is about 2/3 shorter than paper. Information is being gathered automatically, and the response rate is almost instant.
Cheaper - You don't have to allocate part of your staff to enter the information into a database. The responses are processed automatically, and the results are accessible at any time, and emailed to doctor directly.
Accurate - Smaller margin of error because participants enter their responses directly into the system.
Quick to Analyze - Online arithmetic and logic operations can be used to analyze the results and provide you with quick answers.
Easy to use - Patients can do it anytime from their home, and the time needed to complete the questionnaires is much shorter.
Customizable - Online questionnaire can be styled and configured to match your specific needs. You have full control over the questions, what to do with the answers, and where to send them.

Goldberg's Depression Questionnaire Sample

Check your depression probability in this Goldberg's Depression Questionnaire.
Results will be displayed at the bottom of the questionnaire.


Online Patient Questionnaires are available for $50 per questionnaire or $125 for up to four questionnaires of your choice. Prices include customization.

Online Patient Questionnaires

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