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1. Did the Clinician review the function and use of the Electrotherapy Device in a manner that you understood?:
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied
How to adjust the Device to provide maximum relief
How to replace the battery
How to replace the Electrodes
How to reorder supplies
How to contact the Clinician by phone
 
 
2. Did you find the following literature helpful and informative?:
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied
Anatomical Electrode Placement Chart
Electrotherapy Overview & Instructions
 
 
 
3. How often did you wear the Electrotherapy Device?:
 
24/7 during the first week as instructed by the Clinician
 
Only when I had time
 
I stopped using it after the first week
 
I never used it
 
Other
 
 
 
4. Did you find the Electrotherapy Device convenient and easy to use?:
 
Yes
 
No
 
Other
 
 
 
5. Did you get pain relief from the use of the Electrotherapy Device?:
 
Yes
 
No
 
Other
 
 
 
6. Did the use of the Electrotherapy Device allow you to reduce the amount of pain medicine that was prescribed to you by your physician?:
 
Yes
 
No
 
Other
 
 
7. Did you have an adverse physical reation during the use of either the Electrotherapy Device or your Pain Medicine (skin irritation, nausea, sedation, constipation, pain, dizziness, nausea)?:
Yes No
Electrotherapy Device
Your Pain Medicine
 
8. How satisfied were you with our Customer Service?:
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied N/A
Follow-up call to the Clinician with device questions
Toll free call to Customer Service to order supplies (electrodes and batteries)
Overall
 
 
 
9. What comments did you share with your physician regarding the use of your Electrotherapy Device?:
 
I'm glad that he prescribed it
 
I was able to reduce the amount of drugs he/she prescribed
 
I didn't get relief from it
 
Other
 
 
10. Overall, how would you rate your experience in dealing with David Payne & Associates, LLC?:
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied N/A
Our Electrotherapy Device
Our Customer Service
Our Professionalism
Our Responsiveness to your needs
Our Website
Overall
 
Please visit us on our Web site: www.acutepayne.com
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