Sleep Disorders Evaluation form
Please complete this form and you will receive your certificate.
Wilson Shepard Education Associates
80 Brandywine Lane, Rochester, New York 14618
(585) 360-4192 ~ FAX (585) 301-4457
Instructions: Please complete the following statement by circling the one number that describes your rating.
The rating scale rates from 1 to 4, where 1=poor, 2=fair, 3=good, 4=excellent