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Patient Satisfaction Survey

Patient satisfaction Survey

Thank you for allowing Synergy DMEPOS to be your product/service provider. We hope that your experience with us was positive, and we ask that you please complete our Patient Satisfaction Survey below. Our team looks forward to learning of your feedback.

Full Name

Email

How would you rate your experience with our administrative and customer service staff?

Friendly/Helpful Pleasant Rude Not acknowledged

Were your financial obligations explained to you?

Yes No Not Applicable

Were Did you receive your device(s) when your provider indicated you would?your financial obligations explained to you?

Yes No

How satisfied are you with your device(s)?

Satisfied Mostly satisfied Neutral Mostly dissatisfied Dissatisfied

Do you use your device(s) daily or some other frequency, if applicable?

Daily 3-5 times per week Less than 3 days per week Not at all Not applicable

If you had any questions, problems, or concerns about your care, were they addressed to your satisfaction and in a timely manner?

Yes No I had no questions

If you had any questions, problems, or concerns about your products, were they addressed to your satisfaction and in a timely manner?

Yes No I had no questions

How would you rate your overall experience with Synergy DMEPOS?

Satisfied Mostly satisfied Neutral Mostly dissatisfied Dissatisfied

How would you rate your overall experience with Synergy DMEPOS?

Satisfied Mostly satisfied Neutral Mostly dissatisfied Dissatisfied

How would you rate your overall experience with Synergy DMEPOS?

Would you recommend Synergy DMEPOS to your friends or family if they had a need for our products / services? Yes No

How would you rate your overall experience with Synergy DMEPOS?

Would you recommend Synergy DMEPOS to your friends or family if they had a need for our products / services? Yes No

Do you have any comments or suggestions that you would like to offer in reference to any of the above questions or otherwise?

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Your Pregnancy Journey is about to take off

Have Questions? Please reach out to our customer support team directly by hitting the contact us button below.

We will answer all of your questions thoroughly and support you every step of the way!

We’re a National DME company certified and accredited in 40+ states. Our MomWell program was clinically developed by qualified healthcare professionals.

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Pregnancy Kit
Resources
Be A Partner
Pregnancy Care Kit FAQ’s
Contact
Satisfaction Survey
Make Payment
Terms and Conditions
Privacy Policy

Contact Info

48521 Warm Springs Blvd. STE 317 Fremont CA. 94539
T. 866.203.9810
Mon-Fri 9am-5pm

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