Go backWhat equipment was supplied to you?CPAP/BIPAP MachineCPAP/BIPAP Supplies Only"*" indicates required fieldsThank you for taking a few minutes out of your day to share your experience with us. Your feedback is incredibly valuable as we continue to improve patient care! * RequiredName* First Last Prior to receiving your PAP machine, did our office staff effectively communicate the process of getting your device?* Was the scheduled delivery of your equipment within an acceptable time frame?* Do you understand the usage requirements set forth by your insurance company?* Do you understand your out of pocket costs with ongoing PAP therapy?* Name of the Setup Technician*Choose OptionAndy MunfordAngela IvesAnna RodriguezAntonio ShieldsBetty RockwellBrandt ToranDoris MarquinaEbbie IsraelFred BishopJanelle RolstadJesse JamesJonathon SchuermannJorge TorresJulie DoellKaitlyn GraysonLaura HolleyLynne ThormanMelinda PriceMichael HayesNick DizonNysha BarberRob CabralOffice TechnicianI don't recallN/ALocation of Service Appointment*Choose OptionN/ATelemedicineMy HomeMy WorkQuality DME OfficesEquipment was ShippedOtherDid the Setup Technician educate you effectively on the proper use and maintenance of your device?* Did the Setup Technician explain to you the Sleep Coach program?* Did the Setup Technician explain the Resupply process?* Did our team remind you to schedule a follow-up appointment with your provider?* Would you recommend Quality DME to your friends and family?* On a scale of 1 to 10, how would you rate your overall experience with Quality DME?*With 1 being very dissatisfied and 10 being extremely satisfied 1 2 3 4 5 6 7 8 9 10Please share any additional comments or suggestions belowCommentsThis field is for validation purposes and should be left unchanged. "*" indicates required fieldsThank you for taking a few minutes out of your day to share your experience with us. Your feedback is incredibly valuable as we continue to improve patient care! * RequiredName* First Last Please answer the following questions regarding your recent experience as a New Supplies Patient.Was our staff professional? Did our staff resolve your inquiries? Was our communication about your order status clear? Do you understand how insurance benefits cover supply costs? Do you understand how to get CPAP supplies in the future? Would you recommend Quality DME to your friends and family? On a scale of 1 to 10, how would you rate your overall experience with Quality DME?With 1 being very dissatisfied and 10 being extremely satisfied 1 2 3 4 5 6 7 8 9 10Please share any additional comments or suggestions belowPhoneThis field is for validation purposes and should be left unchanged.
