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MEDEVOLVE CUSTOMER SATISFACTION SURVEY
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Name of Hospital / Facility
*
About the Product:
About the Product:
Consumables
Equipment
Service
Type of Equipment:
EMG/EP
EEG
IONM
Have you used the product before?
Yes
No
Your Experience:
How did you rate the Customer Service?
Very satisfied
Satisfied
Dissatisfied
Very Dissatisfied
How well did we understand your requirements?
Very satisfied
Satisfied
Dissatisfied
Very Dissatisfied
Product Feedback:
How would you rate the condition of the product?
Very satisfied
Satisfied
Dissatisfied
Very Dissatisfied
How would you rate the support provided?
Very satisfied
Satisfied
Dissatisfied
Very Dissatisfied
How would you rate the product performance?
Very satisfied
Satisfied
Dissatisfied
Very Dissatisfied
How does this equipment meet your protocols/clinical standards?
Very satisfied
Satisfied
Dissatisfied
Very Dissatisfied
The next section uses the following categories, please respond to each question with only one response.
Would you use the product again?
Very Likely
Likely
Unlikely
Very unlikely
Would you recommend the product to a colleague?
Very Likely
Likely
Unlikely
Very unlikely
Additional Comments:
Do you wish to be contacted regarding your feedback?
*
Yes
No
How would you like us to contact you?
Email
Telephone
Your email address:
Your Telephone Number
Submit
