Survey

Clinician*

Product*

Please tell us your opinion about the service you received from this clinician by completing the survey below. Your individual responses will be kept strictly confidential. Thank you for your help.

Were you satisfied with the service provided by this clinician and MedEast?*

Yes
No
Unable to comment (don’t remember, not sure, etc.)

Did this clinician provide you with clear instructions for using/wearing this product?*

Yes
No
Unable to comment (don’t remember, not sure, etc.)

Did the clinician ensure the product fit you properly and is comfortable for you to use?*

Yes
No
Unable to comment (don’t remember, not sure, etc.)

Did this clinician give you an expected timeframe for the delivery of your product?*

Yes
No
Unable to comment (don’t remember, not sure, etc.)

Were the insurance/payment benefits clearly provided by our administrative team?*

Yes
No
Unable to comment (don’t remember, not sure, etc.)

Were you given information on how to get in touch with the clinician or MedEast if you had a follow-up question or a concern?*

Yes
No
Unable to comment (don’t remember, not sure, etc.)

How would you rate your overall experience with this clinician and MedEast?*

Excellent
Good
Fair
Poor
Unable to comment (don’t remember, not sure, etc.)

Comments

Patient Satisfaction Survey