CUSTOMER SATISFACTION SURVEY
The purpose of this survey is to gather information that will help us provide better customer service to you and your residents. Your responses are strictly confidential and will only be used to evaluate how we are doing as an organization. At BPUC, our number one goal is to provide you with the best care and service available. Thank you for your time and participation.
Which Assisted Living Community are you affiliated with?
Your answer
What is your role at this Assisted Living Community?
Executive Director
Resident Care Director/Coordinator
Business Office Manager
Resident
Resident Family Member / POA
Other:
Clear selection
Who is the BPUC Provider at your community?
Amy Espinoza, FNP
Angela Kellermeyer, PA-C
Carolyn Mueller, FNP-C
Christine Palmer, AGNP-BC
Connie Kurth, PA-C
Dan Radelescu, ANP-C
Joy Ciaccio, FNP-C
Kelli Honeycutt, ANP-C
LaToya Lucas, ANP-C
Leslie King, AGNP
Nancy Tallent, PA-C
Clear selection
How would you rate the BPUC Provider's' attentiveness to your resident's medical needs?
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Other: Please provide us with details at the end of this survey
Clear selection
How would you rate the time it takes to receive physician's notes, orders, consults, etc. from BPUC?
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Other: Please provide us with details at the end of this survey
Clear selection
How would you rate the response time when contacting your BPUC Physician when they are away from your building?
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Other: Please provide us with details at the end of this survey
Clear selection
How would you rate the response time when contacting our 24/7 On-Call Physician Services?
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Other: Please provide us with details at the end of this survey
Clear selection
How would you rate the ease and usefulness of the BPUC Online Portal?
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
We would like additional training on the BPUC Online Portal
Other: Please provide us with details at the end of this survey
Clear selection
How would you rate the customer service provided by BPUC Assisted Living On-Site Care?
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Other: Please provide us with details at the end of this survey
Clear selection
How would you rate the overall services provided by BPUC Assisted Living On-Site Care?
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Other: Please provide us with details at the end of this survey
Clear selection
Please provide feedback regarding the BPUC provider that is assigned to your Assisted Living Community.
Your answer
Please provide feedback regarding the BPUC 24/7 On-Call Physician Services.
Your answer
Please provide feedback regarding the BPUC Online Portal.
Your answer
Please provide feedback regarding BPUC's Customer Service.
Your answer
Please provide feedback regarding the overall services provided by BPUC.
Your answer
Please provide us with additional comments and/or questions you may have regarding BPUC. For example: What can we do better? What other services would you like to see BPUC provide? Etc.
Your answer
Thank you for taking the time to complete this survey. At BPUC, we care about the quality of YOUR care. The answers in this survey will help us understand how we can serve you and your residents better.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
