Client Satisfaction Survey
2nd Quarter (Apr-May-Jun 2017) Client Satisfaction Survey
Survey Number *
Your answer
The person completing this survey is the *
Required
Client gender *
Required
Client age *
Required
How long have you received services from Preferred Choice Healthcare? *
Required
Which Preferred Choice Healthcare office do you most often use? *
Required
At appointment time, how long do you generally wait between arrival and being seen? *
Required
Rate the quality of professional and courteous service provided by our administrative staff. *
Required
Rate the quality of professional and courteous service provided by our clinical staff. *
Required
Do you believe the staff at Preferred Choice Healthcare respects your morals, values and beliefs? *
Required
Would you say our offices are clean and safe? *
Required
Did you have input into the development of your goals and treatment plan?
Have you received a copy of your treatment plan? *
Required
Were you informed of how to access after hours emergency assistance? *
Required
Rate the evaluation of your progress *
Required
Would you recommend Preferred Choice Healthcare to someone else? *
Required
How would you rate your overall satisfaction with Preferred Choice Healthcare? *
Required
Do you have any comments or suggestions?
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