Chime Hearing Centre

Chime Hearing Centre

Patient Satisfaction Survey.
Name (Optional)

First NameLast Name
Phone Number (Optional)

Area CodePhone Number
Email (Optional)
example@example.com
How happy were you with your assessment, fitting and aftercare?

1

2

3

4

5

1 is Worst, 5 is Best
How did you find the atmosphere of the facilities?

1

2

3

4

5

1 is Worst, 5 is Best
How accessible was the clinic for your needs?

1

2

3

4

5

1 is Worst, 5 is Best
Did the information given prior to the appointment prepare you for what to expect during the appointment?

1

2

3

4

5

1 is Worst, 5 is Best
How well did we deal with your queries, via phone / email?

1

2

3

4

5

1 is Worst, 5 is Best
How was the professionalism of the administrative staff?

1

2

3

4

5

1 is Worst, 5 is Best
How was the professionalism of the clinical staff?

1

2

3

4

5

1 is Worst, 5 is Best
How happy were you with the product or equipment we provided for you?

1

2

3

4

5

1 is Worst, 5 is Best
How appropriate was the cost of the product or equipment provided?

1

2

3

4

5

1 is Worst, 5 is Best
How accessible are appointments and aftercare?

1

2

3

4

5

1 is Worst, 5 is Best
Would you recommend our service to your friends and family?

YesNo
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