Monroe Oxygen & Medical Equipment Customer Satisfaction Survey

Help us ensure our service is the best in the area!! Please indicate your opinion of our performance by checking the appropriate box next to the question. If one of the questions does not apply to you, please indicate "N/A"
	Name (optional)
	Male Female	Date
	E-Mail Address

		Strongly Agree	Agree	Dis-agree	Strongly Disagree	N/A
1.	Our staff is courteous and helpful.
2.	Our equipment or supplies were delivered promptly.
3.	The equipment was clean when delivered
4.	Adequate instructions were provided for safe use of the equipment.
5.	Your financial responsibilities were appropiately explained.
6.	Our after hours / on call policy was explained
7.	I would recommend Monroe Oxygen & Medical Equipment's services to my friends and family.
8.	The services I recieve meet my healtcare needs
	Additional Comments: