EXIT

ADX BXDX Customer Satisfaction Survey

Question Title

* 1. Contact Information

Name:

Practice:

Address:

Address 2:

City/Town:

State:

ZIP:

Email Address:

Phone Number:

Question Title

* 2. How would you rate our customer service when you call?

Not Satisfied

Somewhat Satisfied

Satisfied

Very Satisfied

N/A

Comments

Question Title

* 3. What is your perception of Turn-Around-Time for pathology reports?

Not Satisfied

Somewhat Satisfied

Satisfied

Very Satisfied

N/A

Comments

Question Title

* 4. How would you rate our courier service?

Not Satisfied

Somewhat Satisfied

Satisfied

Very Satisfied

N/A

Comments

Question Title

* 5. How satisfied are you with your sales representative?

Not Satisfied

Somewhat Satisfied

Satisfied

Very Satisfied

N/A

Comments

Question Title

* 6. How would you rate our billing service to PATIENTS?

Not Satisfied

Somewhat Satisfied

Satisfied

Very Satisfied

N/A

Comments

Question Title

* 7. How likely are you to recommend our laboratory services to other physicians?

Extremely likely

Very likely

Moderately likely

Slightly likely

Not at all likely

Comments

Question Title

* 8. Would you like a representative to contact you to address an immediate issue?

YES

If Yes, Please provide your name and contact information