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Surveys
2006
March
H
home_buer
home_buer
0%
How did you find your dentist?
Referral by friend/neighbor
Referral by acquaintance
Referral by another dentist
Referral by doctor
Advertisement
Phone book
Saw office/sign
Other
How satisfied are you with the skill and competency of the staff?
Very satisfied
Somewhat satisfied
Neutral
Somewhat dissatisfied
Very dissatisfied
Not sure
Does the hospital have equipment for modern diagnosis and treatment?
Yes
No
Not sure
Does the hospital have modern operating room facilities?
Yes
No
Not sure
How satisfied are you with the following:
Overall cleanliness of the hospital
Very satisfied
Somewhat satisfied
Neutral
Somewhat dissatisfied
Very dissatisfied
Not sure
Efficiency of nursing care
Very satisfied
Somewhat satisfied
Neutral
Somewhat dissatisfied
Very dissatisfied
Not sure
Friendliness and courtesy of the staff
Very satisfied
Somewhat satisfied
Neutral
Somewhat dissatisfied
Very dissatisfied
Not sure
The following set of questions deals with medical examination services. These services perform routine examinations like the kind that are used to qualify for life insurance.
Not At All Important
Somewhat Unimportant
Neutral
Somewhat Important
Very Important
Not applicable/
Not sure
Speed in completing examination and reports
Accuracy and completeness in filling out your report
Expertise of medical staff
Medical representative treatment of your client
Offers all services required for examination
Wide geographic area of service coverage
Hand delivery of reports to insurance office
Personal relationship with a representative of the agency
How would you rate on each of the following items?
COMPANY
Excellent
Very Good
Good
Fair
Poor
Not applicable/
Not sure
Speed in completing examination and reports
Accuracy and completeness in filling out your report
Expertise of medical staff
Medical representative treatment of your client
Offers all services required for examination
Wide geographic area of service coverage
Hand delivery of reports to insurance office
Personal relationship with a representative of the agency
Overall, how satisfied are you , with [PRODUCT/SERVICE]?
Very satisfied
Satisfied
Neutral
Dissatisfied
Very dissatisfied
Would you recommend [PRODUCT OR SERVICE] to others?
Definitely
Probably
Maybe
Probably not
Definitely not
Never used
In thinking about your most recent experience with [COMPANY], how satisfied are you with the customer service you received:
Very satisfied
Satisfied
Neutral
Dissatisfied
Very dissatisfied
N/A
The customer service representative was very courteous.
Strongly Disagree
Somewhat Disagree
Neutral
Somewhat Agree
Strongly Agree
The customer service representative handled my call quickly.
Strongly Disagree
Somewhat Disagree
Neutral
Somewhat Agree
Strongly Agree
The customer service representative was very knowledgeable.
Strongly Disagree
Somewhat Disagree
Neutral
Somewhat Agree
Strongly Agree
The waiting time for having my questions addressed was satisfactory.
Strongly Disagree
Somewhat Disagree
Neutral
Somewhat Agree
Strongly Agree
The Process
The following questions pertain to the process by which your most recent service contract was handled. Please indicate whether you agree or disagree with the following statements.
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
The waiting time for having my questions addressed was satisfactory
My phone call was quickly transferred to the person who best could answer my question
The automated phone system made the customer service experience more satisfying
Please contact
[email protected]
if you have any questions regarding this survey.
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