Customer Satisfaction/Feedback Professional & Personalized Respiratory Care Question Title * 1. How likely is it that you would recommend Complete Respiratory Care to a friend or colleague Extremely likely Very likely Somewhat likely Not so likely Not at all likely OK Question Title * 2. Are you: an Oxygen Customer a CPAP Customer OK Question Title * 3. Which location did you visit or have contact with? Alliston Carleton Place Carlingwood Collingwood Cornwall Drummondville Hamilton Hawkesbury London Orleans Princeville Timmins Vaughan (Viceroy) Victoriaville Winchester OK Question Title * 4. If you would like to provide the name of the Complete Respiratory Care representative who you dealt with, please do so (Optional): OK Question Title * 5. Overall, how satisfied were you with the courtesy, friendliness, and politeness of your Complete Respiratory Care representative? Strongly Satisfied Satisfied Neither Satisfied nor Dissatisfied Dissatisfied Strongly Dissatisfied OK Question Title * 6. Overall, how satisfied were you with the professionalism and expertise of your Complete Respiratory Care representative? Strongly Satisfied Satisfied Neither Satisfied nor Dissatisfied Dissatisfied Strongly Dissatisfied OK Question Title * 7. The Complete Respiratory Care representative was warm and approachable Strongly Agree Agree Neither Agree nor Disagree Disagree Strongly Disagree OK Question Title * 8. The Complete Respiratory Care representative was eager to help with my questions/issues Strongly Agree Agree Neither Agree nor Disagree Disagree Strongly Disagree OK Question Title * 9. The Complete Respiratory Care representative was patient and listened to my concerns. Strongly Agree Agree Neither Agree nor Disagree Disagree Strongly Disagree OK Question Title * 10. The Complete Respiratory Care representative was knowledgeable about the product or services. Strongly Agree Agree Neither Agree nor Disagree Disagree Strongly Disagree OK Question Title * 11. Is there anything else you would like to tell us? (optional) OK Question Title * 12. If you would like to provide contact information such as a phone number or email address so a Complete Respiratory Care representative can follow-up on your feedback or if we have questions, please do so here. NAME (Optional): PHONE NUMBER (Optional): EMAIL ADDRESS (Optional): OK DONE