1. Custom Care Orthotics Survey

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

  Strongly Agree Agree Disagree Strongly Disagree
Please choose one answer

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

  Strongly Agree Agree Disagree Strongly Disagree
Please choose one answer.

* 3. Was our staff helpful and friendly?

  Strongly Agree Agree Disagree Strongly Disagree
Please choose one answer.

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

  Strongly Agree Agree Disagree Strongly Disagree
Please choose one answer.

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

  Strongly Agree Agree Disagree Strongly 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 Agree Agree Disagree Strongly Disagree
Please choose one answer.

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

  Strongly Agree Agree Disagree Strongly Disagree
Please choose one answer.

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

  Strongly Agree Agree Disagree Strongly Disagree
Please choose one answer.

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

  Very good Good Poor Very Poor
Please choose one answer.

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

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