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CPAP/BIPAP Machine Survey
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Thank 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!
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Required
Name
*
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 Option
Angela Ives
Anna Rodriguez
Antonio Shields
Betty Rockwell
Brandt Toran
David Russell
Doris Marquina
Ebbie Israel
Fred Bishop
Janelle Rolstad
Jesse James
Jillian DeVine
Jonathon Schuermann
Jorge Torres
Julie Doell
Kaitlyn Grayson
Khriston Wilson
Laura Holley
Lynne Thorman
Melinda Price
Michael Hayes
Nick Dizon
Nysha Barber
Rob Cabral
Office Technician
I don't recall
N/A
Location of Service Appointment
*
Choose Option
N/A
Telemedicine
My Home
My Work
Quality DME Offices
Equipment was Shipped
Other
Did 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
10
Please share any additional comments or suggestions below
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