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Customer Opinion Survey


Customer Opinion Survey

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  • Yes No
  • Yes No
  • Yes No
  • Yes No
  • Yes No
  • Yes No

    • FOR CPAP PATIENTS ONLY

    • Yes No
    • Yes No
    • Yes No

    • FOR OXYGEN PATIENTS ONLY

      If you received OXYGEN EQUIPMENT, do you have any questions regarding how to contact the company after hours, via our company telephone number, in case you need to call for after-hours equipment service? (If yes, please list your name and phone number at the end of the survey and we will contact you to explain the process. )

    • If you would like to have customer service contact you, please type your name and telephone number below:

    • WE APPRECIATE YOUR TIME TO COMPLETE THIS SURVEY. THANK YOU.