Full Name
*
First Name
Last Name
Regence ID Number (including Alpha Prefix)
*
My services/equipment were provided in a timely manner
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Yes
No
Not Applicable
My durable medical equipment needs were met through the services/equipment provided
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Yes
No
Not Applicable
I would recommend this company to my friends or family
*
Yes
No
Not Applicable
I was satisfied with the quality of the equipment I received
*
Yes
No
Not Applicable
Equipment was clean and in good working order
*
Yes
No
Not Applicable
The representatives were professional and courteous
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Yes
No
Not Applicable
Explanations and instructions (manuals) included with equipment were adequate
*
Yes
No
Not Applicable
All procedures were explained prior to performing them
*
Yes
No
Not Applicable
The staff discussed my rights and responsibilities and financial obligations
*
Yes
No
Not Applicable
Comments
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