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Rate Our Visit
Rate Our Home Visit
We’d like to know how you’d rate the visits or service calls we make to your home. We count on our clients to help us improve our services and find the best ways to meet your needs.
If you’ve recently had a home visit from a Respiratory Therapist or a Biomed Technician, please take a minute to fill in the form below.
Thank you very much for your input.
*
First and Last Name
*
BCITS staff person
*
Reason for the visit
*
Date of Visit
September 2010
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37
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38
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39
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40
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41
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Please tell us how you rate the service or assistance you received.
Very Poor
Poor
OK
Good
Very Good
Are there any other comments you'd like to make about the visit?
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