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Patient Satisfaction Survey

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thank you for your feedback!

We appreciate the opportunity to improve our service to you.

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Optional Identification Information

Select date MM slash DD slash YYYY

overall experience

Overall, are you satisfied with your latest experience with ēlizur?**
Did our team members clearly identify themselves as ēlizur representatives?**
Did our team members treat you with courtesy and respect?**
Did our team members explain things in a way that was easy to understand?**
Would you recommend ēlizur to family and friends?**

ēlizur in-person product training

Did you receive a product from ēlizur?*

ēlizur support team

Did you interact with any ēlizur team members over the phone?*

everything else

Please use this space to provide any additional comments and/or feedback you may have. You are welcome to identify any ēlizur team member who provided you with excellent service, or who unfortunately did not exceed your expectations. As we are committed to ensuring your privacy, this form intentionally does not require any sensitive contact information. If you would like us to respond to any of the information you are sharing, please enter your PA#, or give us a call. Thank you.
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