Patient Survey

Your doctor referred you to Maximum Medical because of our quality medical equipment and our commitment to patient satisfaction. Our goal is to make sure that the equipment and the service you receive is beneficial and helpful to you. Please complete this Patient Care Survey so we may evaluate our products and services and continue to enhance them to best serve your needs. Thank you for allowing Maximum Medical to assist you during your recovery and rehabilitation.

Your Name (optional)

Physician's Name (optional)

Was the Brace delivered in time, as promised?(Required)
What was the method if delivery?(Required)
Was the delivered Brace in good condition?(Required)
Was our representative courteous and helpful in explaining the use and care of Maximum Medical Brace?(Required)
After instruction, did you feel comfortable using and maintaining your brace?(Required)
Did you receive our welcome letter with our toll-free number and contacts for questions, supplies, problems, return or repairs?(Required)
Were your rights and responsibilities as a patient explained to your satisfaction?(Required)
Did your physician discuss the recovery benefits and reasons for prescribing this device?(Required)
If friends or family members were having a similar problem or surgical procedure, would you recommend the use of our equipment and services to them?(Required)