Patient Satisfaction Survey
Please complete this form to help us improve our level of Service and Care.
Patient Name (optional)
Equipment Type
(please check all that apply)
Did RT Medical deliver your equipment and/or supplies on time?
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Did RT Medical deliver your equipment and/or supplies accurately?
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Was the training and consultations effective in educating you or your caregiver on your service, care and therapy?
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Educational materials and instructions were adequate to teach me or my caregiver on the product(s)?
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Was our staff courteous and helpful?
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Were your financial responsibilities explained in a satisfactory manner?
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Did you receive advice or help when needed during and after office hours?
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The services and supplies you received made a positive impact on the outcome of my care and/or therapy?
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RT Medical's Patient Service / Care Plans improved the outcome of my care and/or therapy?
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I would recommend your service to my friends or family?
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Compliments or Complaints? Please let us know.
Thank you for allowing RT Medical to serve you!
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