Customer Survey

Thank you for choosing Beltone.
In our on-going efforts to provide a unique high level of customer service experience we are sending you this follow up to ensure we have met and exceeded all your expectations. Please take a few minutes to tell us about your recent experience with us.

Customer Survey

Name *

Date of Appointment *

Location *

Was this your first visit with NCBeltone? *

YES

What was the reason for your visit? *

Were you greeted when you arrived? *

YES

Was the office clean and inviting? *

YES

If NO, please describe. *

Which hearing care practitioner/s assisted you?

Which of the following words would you use to describe our products and services? *

Disappointing

Okay, but there are some issues

Good

Great

Life-Changing

Not Using Any

How well does our product meet your needs? *

Poorly

Well

Good

Above Expectation

Did we answer any questions or concerns about our products or services? *

Did Not Answer My Questions

Partially Answered My Questions

Answered All My Questions

Have you received a follow up communication from our office or the hearing practitioner since your visit? *

YES

How can we improve your experience with NCBeltone?

In your own words, what would you say to someone who asked about us?

What made you choose NCBeltone over another hearing provider?

On a scale from 0 to 10, how likely are you to recommend our company to a friend or colleague? (0 is not likely and 10 is very likely) *

Contact Us

800.581.5082

[email protected]

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800.581.5082 • [email protected]