How Are We Doing?

We are committed to providing the highest quality and service possible. Please help us by completing this survey. Be assured that your responses will be used solely to improve our services and ensure that we meet your expectations. We appreciate your comments and the opportunity to serve you.

* 2. Please rate your degree of satisfaction by checking the box that best reflects your opinion for each of the following questions/statements.

  Excellent Good Average Fair Poor Not Applicable
The equipment and/or supplies were delivered at the agreed upon time.
The equipment and/or supplies were clean when received.
The equipment operates properly.
Adequate instructions were provided for the safe use of the equipment.
That staff was courteous and helpful.
Our response to your questions, problems and concerns was timely.
Our business practices allow easy and understandable access to equipment, items, services, and information.
My financial responsibility was explained.
The after-hours/on-call policy was explained.
Overall, the services I received were to my satsifaction.

* 3. What equipment and/or supplies did we provide to you?

* 4. We appreciate any comments or suggestions on how we could improve safety:

* 5. We appreciate any other comments or suggestions:

* 6. Optional information:

Thank you for completing our patient/client satisfaction survey.