PATIENT SURVEY
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PDSHEART believes in taking a hard look at ourselves. We believe that by doing this we can see the company through your eyes. In our constant struggle to make this a better company please take time to fill out the following. Thank you for taking the time to send us the following information.
Please note: if you are not a Patient, have never been a patient or have already mailed in the Patient Survey Form from your monitor pack, Please do not fill out this form.


Please rate each of the following and check off the appropriate box:

1.        Overall quality of service.

Excellent Very Good Good Fair Poor

2.        Convenience of our service.

Excellent Very Good Good Fair Poor

3.        Training you received on the monitor from your physician's office.

Excellent Very Good Good Fair Poor

4.        Training you received on the monitor by phone from PDSHeart technicians.

Excellent Very Good Good Fair Poor

5.        Written materials (easy to read, complete and helpful).

Excellent Very Good Good Fair Poor

6.        Attention given to your comments and concerns.

Excellent Very Good Good Fair Poor

7.        Professionalism and courtesy of the PDSHeart staff.

Excellent Very Good Good Fair Poor

8.        PDSHeart staff knowledgeable and helpful regarding questions you had?.

Excellent Very Good Good Fair Poor

9.        Would you recommend PDSHeart to others who need this type of service?

Yes     No 

10.        Comments: Please let us know about any experiences / incidents with PDSHeart (technicians, monitor, etc)  that impressed or disappointed you.   In addition, we highly value your comments and suggestions on areas of improvement and ways we can better serve our customers.

11.        Optional Information:

Age:
Name:
Address:
City & State:
I would like to be contacted regarding my comments.

When you click on "Submit Form" you will see all information that has been transmitted.