DME - Patient Satisfaction Survey
We would appreciate your feedback regarding our durable medical equipment services. Please be forthright and honest so that we can continue areas of strength and improve areas of weakness.
How long was your wait to schedule your services with a DME representative from our office?
Didn't wait - seen upon request
Same day or next day
Within a week
More than 1 week
More than 2 weeks
How easy or difficult was it to schedule your appointment at a time that was convenient for you?
Neither easy nor difficult
How well do you feel TPSC's DME representative understood your needs?
Not at all well
How knowledgeable did TPSC's DME representative seem during the instruction and explanation of the DME device and supplies?
Not at all knowledgeable
Would you say that TPSC's DME representative was able to provide you with a comfortable and appropriately fitting mask?
Were you informed of your financial responsibility prior to your appointment?
Was the financial information you received prior to your appointment easy to understand?
How well did TPSC's DME representative explain the use and care of the machine and supplies?
Not very well
Not at all well
Please choose from the following options which best describes your overall DME customer service satisfaction received.
Neither satisfied nor dissatisfied
Please share your comments:
How likely would you be to recommend TPSC's DME services to a friend or family member?
Not at all likely
Patient Name (optional)
Date of appointment or interaction (required)
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This form was created inside of Texas Pulmonary & Critical Care Consultants.