Satisfaction assessment (Piyavar product's score)

Visitor Information

Full Name: *

Name of Centre / Unit: *

Position:

Phone: *

Address:

Fax:

Mobile:

Email:

Bedside:

	Very Good	Good	Barely Good	Poor	Very Poor
Bedside’s height from the frame
Bedside length
Bedside locking mechanism
Bedside appearance

Bed Appearance:

Bed Locker:

	Very Good	Good	Barely Good	Poor	Very Poor
Bedside locker dimensions
Bedside locker appearance
Bedside locker strength
Bedside locker castors strength

Over Bed Table:

	Very Good	Good	Barely Good	Poor	Very Poor
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 Good	Good	Barely Good	Poor	Very Poor
After sales services execution
After sales services staff behavior
After sales services expectation time
Training in time of installation

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