Online Patient Survey

Please use the following scale:
1= Unacceptable | 2 = Acceptable | 3 = Above Average | N/A = Not Applicable

Appointments were available and scheduled in a timely manner:
N/A123

I was seen at my scheduled appointment time:
N/A123

Overall satisfaction with the service received from Everything CPAP staff:
N/A123

I received adequate information about the treatment process including care and
use of my device:
N/A123

Written and verbal instructions on how to use the device were clearly
communicated:
N/A123

I received information on how to contact the office concerning any questions or
concerns I might have:
N/A123

Overall satisfaction with the quality your experience at Everything CPAP:
N/A123

Likeliness of recommending Everything CPAP to others?:
N/A123

Additional Comments or Suggestions:

Your Name (optional)

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