Team Makena: Compliance - Patient Survey

Your doctor referred you to Team Makena because of our quality medical equipment and our commitment to patient satisfaction. Our goal is to make sure that our equipment and the service you receive are beneficial and helpful to you.

When you have a question or need assistance, please call 949.474.1753.

Please complete this Patient Care Survey so we may evaluate our products and services and better understand the needs of our patients. Thank you for allowing Team Makena to assist you during your recover and rehabilitation.

     Your Name:

     Your Email:


1. Equipment Type:


2. How long have you been using the equipment?:


3. Was the equipment delivered on time as promised?:


4a. Was the delivered equipment clean and in working condition?:

4b. If no, what was the condition?:


5. Was our DME Technician helpful and courteous in explaining the use and care of
    the equipment?:


6. After instruction, did you feel comfortable using and maintaining your equipment?:


7. Were you advised for whom to contact for questions, supplies,
    problems, equipment return and equipment repairs?:


8. If you called our office during regular business hours, was your call answered promptly?:


9. If you called our office after regular business hours, was your call answered promptly?:


10. When were you given the equipment?:


11. If your friends or family members were having a similar problem or surgical procedure,
     would you recommend the use of our services and equipment to them?:


12. Additional Comments: