Huestis Medical - Customer Satisfaction Survey

Customer Satisfaction Survey

We would like to take this opportunity to thank your for purchasing a Huestis Medical product. Quality of service and your satisfaction are very important to our goal of continuous improvement.

You, the customer, are the only real source we have of monitoring our product satisfaction level. We would appreciate it if you would take a moment of your time and indicate your feelings about this project and the equipment you have received. We feel your evaluation is very helpful for us to continue to provide the very best quality equipment possible.

Please fill out the following form as accurately and completely as possible.

I Have Purchased The Following Product(s):

Radiotherapy Products

Radiotherapy simulators
Shielding block cutters
Beam compensator milling systems
X-ray cassette holders
Breast incline board
Radiotherapy thermoplastic
Calipers
Head & neck immobilization
Foam blocks, alloy, other supplies
Other radiotherapy product

Remanufactured Diagnostic Imaging Systems

Remaufactured GE R/F system
Remanufactured GE AMX portable
Remanufactured GE CT system
Remanufactured OEC C-arm
Remanufactured Liebel-Flarsheim Uro suite
Other remanufactured system

X-ray collimators

Manual collimator
Selectable collimator
Other collimator

(Please list additional products in text box provided below)

I would like a reply to be sent by:

I would also like someone to call me:
yes no

My Personal Information:

First Name

Last Name

Middle Initial

Title

Organization

Work Phone

Fax

E-mail Address (required)

Street Address

City

State

Zip Code

Country

Dealer:

If you purchased your Huestis Medical equipment from a dealer, please enter the dealer's name here:

Dealer Name

Job Reference Number:

If your were given a job reference number, please enter it here:

Reference Number

Questions:

Please check the level of satisfaction, 1 being the lowest and 10 being the highest.

1. What would you say is your overall level of satisfaction with the dealer throughout this transaction?

1 2 3 4 5 6 7 8 9 10
Explain:

2. Did the equipment meet your expectations?

1 2 3 4 5 6 7 8 9 10
Explain:

3. Did service and sales take the time to install and explain the equipment properly?

1 2 3 4 5 6 7 8 9 10
Explain:

4. When you need to purchase more equipment, would you consider a Huestis Medical product again?

1 2 3 4 5 6 7 8 9 10
Explain:

Additional Comments or Suggestions:

Thank you for taking part in this survey. What you think about our services is very important to us. If you were pleased with the equipment purchased, we would greatly appreciate your comments on your letterhead for our wall display. If you were not satisfied with the products from Huestis Medical, we would also like to hear about that.

We can be contacted at 800-972-9222 or sales@huestis.com.
If at any time you do need to contact us about this equipment please help us identify your order by referencing your job number. Thank you for your patronage.

Best Regards,
Huestis Medical