Clinical Engineering Department - Customer Satisfaction Form
Please take a moment to complete this form, as it will help us improve our services. Your feedback will be used for continuous improvement purposes.
Name
First Name
Last Name
Department
Date of service
-
Month
-
Day
Year
Date
Service Type
Medical Device Maintenance
Medical Device Repair
Contracts
Technical Support
Medical Device Procurement
Medical Device Training
Other
Overall satisfaction of service
Rows
Very unsatisfied 1
Unsatisfied 2
Neutral 3
Satisfied 4
Very satisfied 5
Overall Quality
Timeliness/ Response Time
Communicatiom
Resolution of issue
Would you recommend our services to other departments?
Yes
No
Maybe
Please let us know if you have any other feedback or suggestions for improvement.
Thank you for your feedback!
Submit
Should be Empty: