Customer Satisfaction Survey
Exit Survey
100%
Please tell us how important these are to you and how satisfied you are with our service.
Importance
Satisfaction
Not Important
Very Important
Not Satisfied
Very Satisfied
1
2
3
4
5
1
2
3
4
5
Crew Knowledge
Crew Professionalism
Crew Appearance
Timeliness during call
Crew Knowledge
Importance
-- Select --
1 Not Important
2
3
4
5 Very Important
Satisfaction
-- Select --
1 Not Satisfied
2
3
4
5 Very Satisfied
Crew Professionalism
Importance
-- Select --
1 Not Important
2
3
4
5 Very Important
Satisfaction
-- Select --
1 Not Satisfied
2
3
4
5 Very Satisfied
Crew Appearance
Importance
-- Select --
1 Not Important
2
3
4
5 Very Important
Satisfaction
-- Select --
1 Not Satisfied
2
3
4
5 Very Satisfied
Timeliness during call
Importance
-- Select --
1 Not Important
2
3
4
5 Very Important
Satisfaction
-- Select --
1 Not Satisfied
2
3
4
5 Very Satisfied
Please rate the following:
Overall Satisfaction
Interaction with Billing Office
Interaction with Crews
Convalescent Scheduling Process
How professional is our Company?
Please list any Comments or Suggestions:
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