Welcome Contact Survey FAQ's Employment 
Survey  


Please tell us what you think of ABC

We strive for continued improvement in the level of customer service and care that we provide.  Please help by sharing your experience with our company with us. Thank you in advance for your participation.

1. Where did you first hear about ABC Prosthetics & Orthotics?
2. How would you assess the quality of service provided by the people at our front window? Excellent 
Satisfactory
Unsatisfactory
3. Were the patient waiting and treatment areas well-maintained?  Yes
No
4. Were you escorted to a patient room in a timely manner? Yes
No
5. Did the practitioner who measured / fit your device treat you courteously and professionally? Yes
No
6. Was your prosthesis / orthosis completed in a timely fashion? Yes
No
7. How would you assess the fit of your prosthesis / orthosis? Excellent
Satisfactory
Unsatisfactory
8. If adjustments were necessary, did the practitioner make them accurately? Yes
No
Not Applicable
9. How would you evaluate the workmanship and appearance of the finished prosthesis / orthosis? Excellent
Satisfactory
Unsatisfactory
10. Did the practitioner give you specific instructions or advice about your prosthesis / orthosis? Yes
No
11. In your opinion, did the practitioner possess the necessary skills to provide you with your prosthesis or orthosis? Yes
No

If no, why?

 
12. 0verall, how would you evaluate the services you received? Excellent 
Satisfactory
Unsatisfactory
13. Would you return to ABC Prosthetics & Orthotics if our services were needed again? Yes
No

If no, why?

 
14. Would you recommend ABC Prosthetics & Orthotics to someone who needed our services? Yes
No
15.

Any additional comments / observations?

 

16. At which office were you seen?

 

Age:
Sex:
Approximate date of last visit:
Service provided: Prosthetic 
Orthotic 
Other 
 Other Details:
 

The following section is optional, but necessary if you would like to be contacted regarding your visit.

Name:
Phone:
Email:
Address:
City:
State:
Zip:

   

 
Did You Know?
ABC Prosthetics & Orthotics accepts most insurances including Medicare, Medicaid, Blue Cross/Blue Shield and Aetna.  We will always file the claims for you so you don't have to.
 
For Your Info...
You can view our entire list of accepted insurances by clicking the Insurance button from our Welcome page.  


 
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