Hello!
Thank you for taking valuable time out of your day to participate in some pleasantly brief Performance and Quality Improvement.
Name (optional)
First Name
Last Name
Email (optional)
example@example.com
1. Were you treated in a courteous and professional manner by or staff?
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2. Were you shown how to correctly use and care for your orthotic or equipment?
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3. Did you receive your device within a reasonable period of time?
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4. Are you pleased with the comfort, function, quality and fit of your device?
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5. Did our staff discuss billing and payment options during your visit?
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Comments (Optional: Tell us we're great...or any other thoughts.)
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