Welcome to Advanced Healthcare
 
 
Satisfaction Survey

It is very important to us that we are meeting the needs of our patients. Please fill out our survey and tell us how we are doing.

*Indicates required fields

First Name*
Last Name*
E-mail Address*
 
 

On a scale from 1-5, please rate our services.

Strongly Agree
Agree
No Opinion
Disagree
Strongly Disagree
5
4
3
2
1

1. Were your medical equipment and supplies delivered in a timely manner?

Strongly Agree
Agree
No Opinion
Disagree
Strongly Disagree
5
4
3
2
1

2. Was your medical equipment clean and in good working order?

Strongly Agree
Agree
No Opinion
Disagree
Strongly Disagree
5
4
3
2
1

3. Were instructions given regarding the proper and safe use of the medical equipment?

Strongly Agree
Agree
No Opinion
Disagree
Strongly Disagree
5
4
3
2
1

4. Were you informed about who to contact regarding future questions?

Strongly Agree
Agree
No Opinion
Disagree
Strongly Disagree
5
4
3
2
1

5. Were your rights and obligations explained to you?

Strongly Agree
Agree
No Opinion
Disagree
Strongly Disagree
5
4
3
2
1

6. Was our staff courteous, knowledgeable, and professional?

Strongly Agree
Agree
No Opinion
Disagree
Strongly Disagree
5
4
3
2
1

7. Would you do business with our company in the future?

Strongly Agree
Agree
No Opinion
Disagree
Strongly Disagree
5
4
3
2
1

8. Would you recommend our company to your family and friends?

Strongly Agree
Agree
No Opinion
Disagree
Strongly Disagree
5
4
3
2
1
Additional Comments
   
 
Copyright 2008 © Advanced Healthcare
All rights reserved. Privacy Policy
 Home Page   |  Contact Us  |  About Us  |  Locate Us  |  Medical Products