Satisfaction assessment (Parameter important grade)

Visitor Information

Full Name: *

Name of Centre / Unit: *

Position:

Phone: *

Address:

Fax:

Mobile:

Email:

Bedside:

	Very Important	Important	Moderately Important	Of Little Important	Unimportant
Bedside’s height from the frame
Bedside length
Bedside locking mechanism
Bedside appearance

Castors:

Head Board:

Jack:

Accessories:

Bed Appearance:

Bed Locker:

	Very Important	Important	Moderately Important	Of Little Important	Unimportant
Bedside locker dimensions
Bedside locker appearance
Bedside locker strength
Bedside locker castors strength

Over Bed Table:

	Very Important	Important	Moderately Important	Of Little Important	Unimportant
Over bed appearance
Over bed strength
Over bed board
Over bed table height adjustment capability
Over bed dimensions
Over bed castors quality

After Sales Services:

	Very Important	Important	Moderately Important	Of Little Important	Unimportant
After sales services execution
After sales services staff behavior
After sales services expectation time
Training in time of installation

Sales:

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Piyavar