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How to Order
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Referral Satisfaction and Performance Survey
Delivery Technicians
1. Do our delivery technicians adequately explain equipment and ensure the customer/patient can operate their equipment?
Poor
Average
Satisfactory
Excellent
2. Are our delivery technicians friendly and compassionate in their interactions with your patients?
Poor
Average
Satisfactory
Excellent
3. How would you rate our delivery technicians ability to provide quality care for your patients?
Poor
Average
Satisfactory
Excellent
Customer Service/Office Staff
4. Please rate our office personnel’s overall willingness to help with product questions or equipment orders.
Poor
Average
Satisfactory
Excellent
5. Rate our customer service staffs’ ability to quickly find answers to questions and their ability to produce solutions to problems regarding equipment, deliveries, or service.
Poor
Average
Satisfactory
Excellent
6. Overall would you say Bellevue Healthcare’s commitment to service?
Lags behind other equipment providers
Compares but does not exceed competitors.
Is at the forefront companies in the home medical equipment industry.
7. Any additional comments about your ordering experience?
Your Name (optional)
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