Customer Satisfaction/Feedback Professional & Personalized Respiratory Care Question Title * 1. How likely is it that you would recommend Complete Respiratory Care to a friend or colleague Extremely likely Very likely Somewhat likely Not so likely Not at all likely OK Question Title * 2. Are you: an Oxygen Customer a CPAP Customer OK Question Title * 3. Which location did you visit or have contact with? Alliston Toronto (Bloor) Carleton Place Carlingwood Collingwood Vaughan (Creditstone) Drummondville Hamilton Hawkesbury Mont Royal Orleans Timmins Vaughan (Viceroy) Victoriaville Winchester OK Question Title * 4. If you would like to provide the name of the Complete Respiratory Care representative who you dealt with, please do so (Optional): OK Question Title * 5. Overall, how satisfied were you with the courtesy, friendliness, and politeness of your Complete Respiratory Care representative? Strongly Satisfied Satisfied Neither Satisfied nor Dissatisfied Dissatisfied Strongly Dissatisfied OK Question Title * 6. Overall, how satisfied were you with the professionalism and expertise of your Complete Respiratory Care representative? Strongly Satisfied Satisfied Neither Satisfied nor Dissatisfied Dissatisfied Strongly Dissatisfied OK Question Title * 7. The Complete Respiratory Care representative was warm and approachable Strongly Agree Agree Neither Agree nor Disagree Disagree Strongly Disagree OK Question Title * 8. The Complete Respiratory Care representative was eager to help with my questions/issues Strongly Agree Agree Neither Agree nor Disagree Disagree Strongly Disagree OK Question Title * 9. The Complete Respiratory Care representative was patient and listened to my concerns. Strongly Agree Agree Neither Agree nor Disagree Disagree Strongly Disagree OK Question Title * 10. The Complete Respiratory Care representative was knowledgeable about the product or services. Strongly Agree Agree Neither Agree nor Disagree Disagree Strongly Disagree OK Question Title * 11. Is there anything else you would like to tell us? (optional) OK Question Title * 12. If you would like to provide contact information such as a phone number or email address so a Complete Respiratory Care representative can follow-up on your feedback or if we have questions, please do so here. NAME (Optional): PHONE NUMBER (Optional): EMAIL ADDRESS (Optional): OK DONE