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LIFESIGNS, Inc. <br />COMMUNICATION SERVICES SURVEY <br />OPTIONAL: (So we may contact you for more information if necessary) <br />Name Phone <br />Please fax this form to LIFESIGNS, Inc. at (323) 550 -4215. <br />Thank you for choosing LIFESIGNS, we appreciate your business! <br />Your feedback is important to us for better meeting our customers' needs <br />1 = Needs improvement 2 = Average 3 = Outstanding <br />1. <br />Professionalism, courtesy and friendliness of staff on the phone 1 <br />2 <br />3 <br />NA <br />2. <br />Ability to contact or reach staff during regular office hours 1 <br />2 <br />3 <br />NA <br />3. <br />Ability to obtain interpreter services when requesting in advance 1 <br />2 <br />3 <br />NA <br />4. <br />How would you rate the interpreter's appearance? 1 <br />2 <br />3 <br />NA <br />5. <br />Was the interpreter on time for the appointment? 1 <br />2 <br />3 <br />NA <br />6. <br />Was the interpreter professional, courteous and friendly? 1 <br />2 <br />3 <br />NA <br />7. <br />Customer service regarding complaints, questions or information 1 <br />2 <br />3 <br />NA <br />8. <br />Would you recommend our service to others? Yes <br />No <br />NA <br />OPTIONAL: (So we may contact you for more information if necessary) <br />Name Phone <br />Please fax this form to LIFESIGNS, Inc. at (323) 550 -4215. <br />Thank you for choosing LIFESIGNS, we appreciate your business! <br />