Satisfaction Survey
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1. Custom Care Orthotics Survey

 

1. Did you find our appointment process to be convenient?

 Strongly AgreeAgreeDisagreeStrongly Disagree
Please choose one answer

2. Did you find that our appointment availability fit your schedule and needs?

 Strongly AgreeAgreeDisagreeStrongly Disagree
Please choose one answer.

3. Was our staff helpful and friendly?

 Strongly AgreeAgreeDisagreeStrongly Disagree
Please choose one answer.

4. During your evaluation, did our staff answer questions you had to your satisfaction?

 Strongly AgreeAgreeDisagreeStrongly Disagree
Please choose one answer.

5. Was the wearing and caring information you were given, both verbal and printed, useful?

 Strongly AgreeAgreeDisagreeStrongly Disagree
Please choose one answer.

6. After your evaluation, did our office staff review your insurance coverage and estimated financial responsibility in a clear, understandable manner?

 Strongly AgreeAgreeDisagreeStrongly Disagree
Please choose one answer.

7. Did you find our staff to be knowledgeable and professional?

 Strongly AgreeAgreeDisagreeStrongly Disagree
Please choose one answer.

8. Would you recommend our services to friends and family?

 Strongly AgreeAgreeDisagreeStrongly Disagree
Please choose one answer.

9. Overall, please rate your experience with Custom Care Orthotics.

 Very goodGoodPoorVery Poor
Please choose one answer.

10. Please share any additional comments regarding your experience with Custom Care Orthotics.

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