In an effort to continuously improve our service; please take a few minutes to complete our survey.
Please rate each item on a scale from 1 - 5
1 = Strongly Disagree
2 = Do Not Agree
3 = Somewhat Agree
4 = Agree
5 = Strongly Agree
N/A = Not Applicable---You did not have this service and can not rate it
1. Our customer service phone staff were courteous and polite
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2. Our delivery arrived at your home within the promised time frame
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3. Your order was complete when you received it
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4. Your order was correct when you received it
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5. We were able to supply all of the products/services you needed
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6. You are aware of other products and services we provide
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7. We were able to address any problems, issues or concerns efficiently
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8. You would refer us to your family or friends for medical supplies and medical equipment services
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If there is anything you want to tell us, good or bad, please use the lines below:
Contact Information (optional):
Referral Satisfaction Survey
In an effort to continuously improve our service; please take a few minutes to complete our survey.
Please rate each item on a scale from 1 - 5
1 = Strongly Disagree
2 = Do Not Agree
3 = Somewhat Agree
4 = Agree
5 = Strongly Agree
N/A = Not Applicable---You did not have this service and can not rate it
1. Customer Service was easily accessible (reasonable hold times)
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2. Ease of placing an order/referral process
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3. Intake staff was knowledgeable, efficient, presented options to consider and questions were appropriate
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4. Our range of services met your needs
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5. Ease of our referral management process (in the event we could not handle your referral and we referred it out to another provider)
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6. The turnaround time from placing the referral to the patient receiving services met your expectations
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7. Quality of care, products and services met your expectations
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8. Respira Medical is a reliable provider who fulfills its promises and offers timely follow up
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9. Our after hours service responded to your needs promptly and efficiently
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10. The Patient Account Representative that calls on your office is knowledgeable and efficient
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11. You would use Respira Medical again and/or recommend us for medical supplies and medical equipment services
N/A
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5
If there anything you want to tell us, good or bad, please use the lines below:
Referral Name/Office (optional):
Shop now by clicking the link above or by calling us toll free at 1-866-373-7747
anytime, day or night (including weekends and holidays) and we'll be happy to assist you with your order.
The Respira Story
In the spring of 2001, Founder and Chief Executive
Officer Y. Maria Martinez began breathing life into what has become a major force within the homecare community. With
a focused drive towards providing the highest level of compassionate service, Maria combined over 25 years of experience in the medical field...