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Customer-Survey
Practice/Clinic/Medical Facility:
Department:
Name
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:
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Are you satisfied with the quality of the products?
very satisfied
satisfied
somewhat satisfied
rather not satisfied
not satisfied
Are you satisfied with the use of the product?
concerns another department
very satisfied
satisfied
somewhat satisfied
rather not satisfied
not satisfied
Are you satisfied with our service?
very satisfied
satisfied
somewhat satisfied
rather not satisfied
not satisfied
Are you satisfied with the delivery time?
concerns another department
very satisfied
satisfied
somewhat satisfied
rather not satisfied
not satisfied
Do you have any feedback, requests or suggestions for improvement?
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