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  Your feedback is important to us. Only by actively listening to our customers, can we deliver the products, services and solutions you require. Please take a moment to tell us how we're doing!  
     
     
  Section 1 (Customer Profile)  
       
  What best describes your current position:  
  CIO/COO  
  IT Director/manager  
  Nurse  
  Director/manager  
  Biomedical Director/Manager  
  Biomedical engineer  
  Respiratory therapist  
    Other (list)  
     
     
  Which service area are you evaluating:  
  Anesthesia  
  Ventilation  
  Perinatal  
  Monitoring  
  Multiple Care Areas  
  IT  
       
  What state are you located in?  
     
       
  Number of beds at your hospital/facility:  
  Less than 200  
  200-500  
  More than 500  
  Integrated Healthcare Delivery Network (IDN)  
       
  What are the leading reasons why your facility purchased Dräger system/systems: Check all that apply  
  Integration capabilities  
  Corporate decision  
  Prior relationship with Dräger  
  Package Deal  
  Functionality  
  Cost  
  Relationship with Sales team  
  Product reliability  
  Service  
       
  What best describes your service relationship with Dräger:  
  Full service contract (Total Care)  
  Preventive Maintenance contract (Preventive Care)  
  No service contract  
       
 
 
       
  Section 2 (Satisfaction Indicators)  
     
  Please provide your impression on the following Service Performance Indicators. Enter a rating between 1-10, 1 being poor and 10 being excellent.  
       
  Installation  
  Quality of Installation  
  Installation performed on-time  
  Quality of Service documentation  
  Problems identified at installation quickly resolved by Dräger Medical  
       
  Call Center  
  Call center access time  
  Call center professionalism  
  Call center problem solving  
       
  Training  
  Quality of Biomed training relative to pace and content  
  Quality of clinical training relative to pace and content  
  Timeliness of clinical training by Dräger clinical application specialist  
       
  Technical Service Representative  
  Emergency call response time  
  Emergency repair fix time  
  Emergency repair quality  
  Timeliness of Preventive Maintenance  
  Service Paperwork complete and on-time  
       
  Corporate/Back Office  
  Timeliness of parts delivery  
  Service contracting experience  
  Service costs are as expected  
  Dräger Sales Representatives take appropriate care of your account?  
       
       
  yes  no
   Dräger is your best vendor.  
   
If not your best vendor, please list your best vendor		  
     
       
  yes  no
   Dräger is your second best vendor.  
   
If not your second best vendor, please list your second best vendor		  
     
       
       
  yes  no
   Would you recommend Dräger to a friend/peer?  
     
  yes  no
   Would you buy Dräger Medical products again?  
       
  Other Feedback  
  In the blank area below, please provide additional feedback important to improving Dräger's satisfaction ratings within your organization  
       
     
       
  I would like DrägerService to contact me  
       
    Hospital:  
     
    Contact name:  
     
    Contact title:  
     
    Contact phone:  
     
    Contact mail:  
     
       
       
     
       
       
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