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System Installation Feedback
Facility Name:
Address 1:
Address 2:
City:
State:
Zip Code:
Contact Name:
Contact Phone:
Contact E-mail:
Date of Install:
Service Engineer:
Type of system installed:
Manufacturer:
System Model:

Was system cosmetically acceptable?
Yes        No
Did Echoserve call to confirm appointment within 2 hours of service request (may not be a service engineer; could be a dispatcher)?
Yes        No
Did the Service Engineer arrive on time?
Yes        No
Did the Service Engineer project a professional image (was he/she dressed appropriately; did they act professionally; etc.)?
Yes        No
Did the Service Engineer appear to be knowledgeable about the system and/or problem(s)?
Yes        No
Did the Service Engineer conduct a thorough test of the system, ensuring proper operation?
Yes        No
Did the system include all hardware, probes, peripherals, and options as stated on purchase order?
Yes        No
Did the Applications Specialist effectively train your clinical staff on using the system?
Yes        No
Did the Applications Specialist address all desired training requirements?
Yes        No
Did the Service Engineer provide a complete Installation Report?
Yes        No
Would you recommend Echoserve to other customers interested in a system purchase?
Yes        No
What is your overall grade for this installation?
Bad
Poor
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Any Additional Comments?
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