Consumer Satisfaction Survey for Marketplace Navigators
Thank you for helping us to improve our services by filling out this brief survey today.
* Required
Indicate the Name of the Navigator Who Assisted You.
*
Choose
Doris Allen
Darnell Barber
Elizabeth Hernandez
Onaney Hernandez
Orlando Hulse
Nancy Bennett
Benny Santos
JoAnn Ortiz
Anne Packham
Milda Elysee Monplaisir
Aracely Robledo
Sonia Oyola
Alex Thomas
How did you hear about Navigator Services? Check the main one that encouraged you to make an appointment
*
Family/Friend Referral
Healthcare.gov website
Television ad or news story
Radio Ad/story/interview
Newspaper article
Event Flyer
Facebook or Twitter Posting
Email
Brochure/Newsletter/Flyer
Medical professional
Agency/organization
Navigator Outreach/Tabletop at Event
Other
If you chose "Agency/Organization" or "Other" to the question above, please indicate the specific source.
Your answer
The navigator treated me with courtesy and respect.
Strongly Disagree
1
2
3
4
5
Strongly Agree
Clear selection
The navigator provided helpful information.
Strongly Disagree
1
2
3
4
5
Strongly Agree
Clear selection
I would refer a family member or friend to this navigator.
Strongly Disagree
1
2
3
4
5
Strongly Agree
Clear selection
Please feel free to provide any feedback about your experience with a navigator today. Thank you!
Your answer
Please provide your name and phone number if you are willing to provide us with a testimonial or want to share your enrollment story with the media.
Your answer
Please provide your name and phone number if you want a call back from a Navigator Supervisor.
Your answer
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