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Customer Satisfaction Survey
Contact Name:
Email:
Phone:
Survey Name:
1. What Home Sleep Care Location did you primarily visit?(Mandatory)
--None--
Brantford / Paris
Waterloo
Owen Sound
2. How long have you been a Home Sleep Care Client??
--None--
0 – 6 months
6 – 12 months
More than 12 months
3. Why did you choose Home Sleep Care as your CPAP supplier?
(
choose all that apply by holding down CTRL key
)
Price
Location
Recommendation
Promotion
Other
4. When dealing with Home Sleep Care, were your concerns addressed in a professional and friendly manner?
--None--
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
5. Were the instructions for the use and care of your equipment clear and understandable?
--None--
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
6. Did your initial set up appointment allow for enough time to ask questions and have all your concerns addressed?
--None--
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
7. Did you find the follow up service, both during and/or after your purchase helpful in your success with CPAP therapy?
--None--
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
8. Did you find the free 30 day trial helpful in your decision in CPAP therapy?
--None--
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
9. Overall, have you been happy with your experience with Home Sleep Care?
--None--
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
10. Would you recommend Home Sleep Care to others?
--None--
Yes
No
11. Please use this space for any addition comments you may have:
12. Would you like us to contact you about any of your comments?
--None--
Yes (If yes, please include your personal contact information)
No