Which Denman Services' affiliate store served you? Adaptive Mobility Systems – 1014 Maine – Quincy IL Denman Direct Retail - 4800 Maine Denman Medical Equipment and Supply – 1020 Broadway – Quincy IL Hannibal Medical Supplies, LLC – 6464 Interstate Court – Hannibal MO Illini Health Services – 321 N. Monroe – Pittsfield IL Macomb Medical Equipment & Supply – 531 E. Grant – Macomb IL Use the following scale for each of the questions below: 5=Excellent 4=Good 3=Average 2=Fair 1=Poor Your input will help us understand what we do well and what we can improve. If there is a reason you feel you cannot score us as a 4 or 5, please include comments so we know how to improve. Please also include name(s) of employees we can recognize for doing a good job. The equipment and/or supplies were available at the agreed upon time - or I was kept informed of any changes. 5 4 3 2 1 Comments The equipment and/or supplies were clean and in good working order when received. 5 4 3 2 1 Comments Instruction was provided for the safe use of the equipment. 5 4 3 2 1 Comments Our staff was courteous. 5 4 3 2 1 Comments Our response to your questions, problems, and concerns was timely. 5 4 3 2 1 Comments Our staff communicated a time frame if product not immediately available and/or offered an alternative. 5 4 3 2 1 Comments Is there anything we can do better - and/or - products/services you would like us to provide? 5 4 3 2 1 Comments Would you like to be contacted regarding any concerns? Yes No Please list the following below if you wish for our staff to contact you. Name First Name Last Name Phone Number Email Address Submit Leave this field blank
