* 1. Thanks for sharing your thoughts with us! How would you rate the service you recently recieved?

  Delighted Satisfied Disatisfied
1. Politeness of the office person when you called for our services?
2. Company's ability to set a scheduled time range that was at your convenience?
3. RN/IBCLC's arrival within that scheduled time range?
4. Politeness of the RN/IBCLC who provided the service?
5. Knowledge of the RN/IBCLC who provided the service?
6. Cleanliness and efficiency of equipment delivered, if applicable.
7. Development of a feeding/sleeping/pumping plan that worked for your family?
8. Were all questions answered to your satisfaction?

* 2. Would you use our company again?

* 3. Would you recommend our company to friends and family?

* 4. What did you like best about working with us?

* 5. What would you encourage us to do differently?

* 6. Any additional services that you wish we would provide?

* 7. May we use your comments in future marketing?

* 8. Name: (OPTIONAL)

* 9. Date:

* 10. Who was the nurse that helped you?