How would you rate your most recent experience with us? *

Excellent

Above Average

Average

Below Average

Poor

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Services were provided in a timely manner *

Yes

No

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The staff informed me how to contact the office *

Yes

No

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The representatives were courteous and professional *

Yes

No

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The equipment and room was clean *

Yes

No

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I was treated with respect

Yes

No

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I would recommend EZ Sleep Club to my friend or family

Yes

No

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Comments (Optional)

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If you would like to be contacted about your concerns, please fill out the form below.

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Patient Name (Optional)

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Contact Number (Optional)

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Email (Optional)

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