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Quality Survey
Hi there! We want to know how we can be better!
Basic Information
Patient Name:
Current Phone:
Email Address:
1. Ease of placing an order or setting up a new account?
Excellent
Average
Needs Improvement
2. Courteous and Knowledgeable customer service?
Excellent
Average
Needs Improvement
3. Staff responded promptly to my needs & provided solutions?
Excellent
Average
Needs Improvement
4. Order processed quickly and accurately?
Excellent
Average
Needs Improvement
5. Selection and quality of merchandise?
Excellent
Average
Needs Improvement
6. Products correct and delivered in a timely manner?
Excellent
Average
Needs Improvement
7. How do you rate our overall service?
Excellent
Average
Needs Improvement
Please indicate any employee(s) that went above and beyond to provide excellent service:
Please elaborate on how the employee provided excellent service (optional):
Are you receiving enough supplies every month?
Answer:
Yes.
No.
Are you happy with the brand we're providing you?
Answer:
Yes.
No.
Other suggestions or comments to improve our service with you:
Submit Form
Submit Survey
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