Thank you for taking the time to complete our customer satisfaction survey. Completion of this survey helps us improve our products and services, so we can make your experience better. Please rate your experience below. HOW SATISFIED WERE YOU WITH... The amount of time you waited to see your orthotist/pedorthist/orthotic fitter? Very Satisfied Satisfied Dissatisfied Very Dissatisfied The professionalism of your orthotist/pedorthist/orthotic fitter? Very Satisfied Satisfied Dissatisfied Very Dissatisfied The amount of time that was spent answering your questions? Very Satisfied Satisfied Dissatisfied Very Dissatisfied The fit and function of the medical device you received? Very Satisfied Satisfied Dissatisfied Very Dissatisfied The overall quality of the medical device you received? Very Satisfied Satisfied Dissatisfied Very Dissatisfied The instructions you were given on how to use and take care of your medical device? Very Satisfied Satisfied Dissatisfied Very Dissatisfied The ability to obtain an appointment at your convenience? Very Satisfied Satisfied Dissatisfied Very Dissatisfied The friendliness/professionalism of our office staff? Very Satisfied Satisfied Dissatisfied Very Dissatisfied The appearance and cleanliness of our waiting area, exam room, and restroom? Very Satisfied Satisfied Dissatisfied Very Dissatisfied The timeliness of our response to any questions, concerns, or issues? Very Satisfied Satisfied Dissatisfied Very Dissatisfied The ease with which you received care and service? Very Satisfied Satisfied Dissatisfied Very Dissatisfied The overall products and services of our company? Very Satisfied Satisfied Dissatisfied Very Dissatisfied Were you provided with a copy of the Patient Bill of Rights? Yes No Did you understand the Patient Bill of Rights? Yes No Were all questions regarding payment or billing handled to your satisfaction? Yes No Was your medical device delivered in the time frame specified by your practitioner? Yes No Is there anything we could do to improve your experience? Is there any individual from our company you would like to acknowledge? Are there any other comments you would like to share? Where did you receive our products/services? - None -at homeat my doctor's office/at the hospitalSurgi-Care's Bangor, ME officeSurgi-Care's Boston, MA officeSurgi-Care's Foxborough, MA officeSurgi-Care's Manchester, NH officeSurgi-Care's Oakland, ME officeSurgi-Care's Portland, ME officeSurgi-Care's Rocky Hill, CT officeSurgi-Care's S. Burlington, VT officeSurgi-Care's W. Springfield, MA officeSurgi-Care's Waltham, MA officeSurgi-Care's Warwick, RI officeOther
