Johnsonville

Your hearing health is extremely important. Which is why an essential part of your appointment today is the completion of this survey.

We need you to do this to ensure that you receive nothing but the highest standards of service on every visit to HearingLife.

To thank you for your time, you’ll automatically be entered into our prize draw to win a $50 Prezzy Card.*

Please select the Region your clinic was located in:*

Please select the name of the clinic you attended for your appointment.*

Your details

First Name

Last Name

Phone (home)

Mobile

Email

Date of appointment*

Clinician ID*

This can be found on the postcard you received from the clinic, if not please contact your local clinic.

Client ID*

This can be found on the postcard you received from the clinic, if not please contact your local clinic. Your Client ID will start with a C followed by a string of numbers.

Your experience with us

1. Based on your experience we would like to understand how you rate our service. How do you feel about the following statements?

Service over the phone to book my appointment was good.

I didn’t have to wait very long to get an appointment at my local clinic.

The customer services consultant on the phone was clear about the time, date and location of my appointment.

The overall level of service provided to me was good.

Your experience in the clinic

2. From your experience today we would like to understand how you rate your clinician. How do you feel about the following statements?

The clinician was very knowledgeable about hearing health.

The clinician explained my options and how to manage the recommended device/s.

The clinician answered all my questions.

(If applicable) The clinician explained that I am eligible to apply for Government assistance/subsidy under the Ministry of Health (MoH), OR Accident Compensation Corporation (ACC) OR Veterans’ Affairs (War Pension) funding.

The clinician made me feel comfortable.

Looking ahead

3. How likely would you be to recommend us to your friends or family (score 0-10) with 0 not at all likely and 10 as extremely likely.

Any further comments

4. Finally is there anything else you’d like to tell us about your experience with HearingLife?

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Your details

Your experience with us

Your experience in the clinic

Looking ahead

Any further comments