QUALITY ONE CARE
PATIENT SATISFACTION SURVEY
Please fill out our brief Customer Satisfaction Survey. All of us at Quality One Care Home Health, Inc. would like to thank you for using our services. We welcome your feedback regarding the care that you receive from us. Your honesty helps us work toward better service for everyone, while ensuring customer satisfaction.
Today's Date *
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How long have you used our agency for nursing/skilled services? *
What services do/did you receive? *
How often do you/did you receive our services? *
Overall, what is your satisfaction level with our customer service? *
Overall, what is your satisfaction level with the Skilled Nursing Services/Other Skilled Services you received? *
Overall, what is your satisfaction level with our Staffing/Scheduling Department? *
Overall, what is your satisfaction level with our after hours on call services? *
Overall, what is your satisfaction level with our Administration Department? *
Overall, how would you rate Quality One Care's services compared to our competitors? *
Would you recommend Quality One Care's services to other people? *
What impressed you most about our services?
Your answer
What disappointed you most about our services?
Your answer
Additional suggestions you would like to share...
Your answer
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