2701 West Broadway | Council Bluffs, IA 51501 | Phone: 712.328.2288 | Fax: 712.328.2299 | Toll Free: 888.798.2288
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Questions For Mobilis
Service Questionnaire
customer Service Questionnaire:
Provide us with your Knowledge of our Service. We Both Win.
Customer Service Questionnaire
We are always seeking ways to be better. The input we receive from our existing customers is valuable so that we can ensure that we are meeting and exceeding your service expectations. We are wanting to hear from you regarding your most recent interaction with a Mobilis representative. Your feedback is much appreciated.
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Indicates required field
Pleae tell us the Equipment/Service Received or Requested?
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Date of Service or Request?
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1) How would you rate your overall satisfaction with Mobilis Home Health Store & Wellness Center?
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5 = Extremely Satisfied
4 = Somewhat Satisfied
3 = Satisfied
2 = Very Dissatisfied
1 = Extremely Dissatisfied
6) How satisfied are you with our response time when you are waiting on product to be delivered?
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5 = Extremely Satisfied
4 = Somewhat Satisfied
3 = Satisfied
2 = Very Dissatisfied
1 = Extremely Dissatisfied
2) How satisfied are you with how well the Mobilis staff performs as promised to you by them?
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5 = Extremely Satisfied
4 = Somewhat Satisfied
3 = Satisfied
2 = Very Dissatisfied
1 = Extremely Dissatisfied
3) How satisfied are you with the knowledge of the Mobilis staff regarding insurance reimbursement, medical necessity documentation and product knowledge?
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5 = Extremely Satisfied
4 = Somewhat Satisfied
3 = Satisfied
2 = Very Dissatisfied
1 = Extremely Dissatisfied
4) Have you ever used another Home Medical Equipment company, other than Mobilis, for similar products and services?
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Yes
No
4a) If Yes (from Question 4) please describe in the box below why you didn't choose Mobilis?
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5) How satisfied are you with the quality of products and services provided by Mobilis?
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5 = Extremely Satisfied
4 = Somewhat Satisfied
3 = Satisfied
2 = Very Dissatisfied
1 = Extremely Dissatisfied
7) How satisfied are you with how courteous, knowledgeable and professional the Mobils staff is to you and your requests?
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5 = Extremely Satisfied
4 = Somewhat Satisfied
3 = Satisfied
2 = Somewhat Dissatisfied
1 = Strongly Dissatisfied
8) How likely are you to continue using Mobilis in the near future?
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5 = Very Likely
4 = Somewhat Likely
3 = Not Sure
2 = Somewhat Unlikely
1 = Very Unlikely
9) Are there areas that you would like to see Mobilis improve? (i.e. Service, Products offered, Store Hours, Staff Availability, Staff Eduction, etc...)
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Yes (See Below)
No
9a) If Yes (from Question 9) please describe the areas in which you would like to see Mobilis improve.
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10) What areas are we doing well that will continue to keep your confidence in us as your preferred provider?
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