Patient Satisfaction Survey

Today's Date *
Today's Date
Name *
Name
Were you greeted in a pleasant manner? *
Were you greeted in a pleasant manner?
Were you instructed on the safety and proper use of your equipment?
Were you instructed on the safety and proper use of your equipment?
Do you feel comfortable operating equipment with instructions given?
Do you feel comfortable operating equipment with instructions given?
Was the technician courteous and knowledgeable?
Was the technician courteous and knowledgeable?
Were all your questions answered?
Were all your questions answered?
Was services provided in a timely manner?
Was services provided in a timely manner?
Were you informed of your financial obligations?
Were you informed of your financial obligations?
Do you understand when you are eligible for new supplies?
Do you understand when you are eligible for new supplies?
Are you comfortable cleaning supplies?
Are you comfortable cleaning supplies?
Were you instructed on who to call with questions or concerns?
Were you instructed on who to call with questions or concerns?