This free survey is powered by QUESTIONPRO.COM
0%
 
 
Hello:

You are invited to participate in our survey [Project Description Here]. In this survey, approximately [Approximate Respondents] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [Approximate Time] minutes to complete the questionnaire.


Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.


Your survey responses will be stricly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below.


Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.


 
 
 
What sector of the health care industry do you believe needs the most improvement in patient satisfaction?
 
Hospitals
 
Physicians
 
Managed-care plans
 
Insurers
 
Nursing homes
 
Outpatient providers
 
Don't know
 
Other
 
 
 
 
What is the most compelling reason for your organization to improve customer satisfaction?
 
Fear of losing patients to competitors
 
Fear of losing employer contracts
 
Fear of increase regulation
 
Fear of damage to organization's reputation
 
Other
 
 
 
In your opinion, has patient satisfaction been shown to have a direct effect on your organization's bottom line?
 
Yes
 
No
 
Don't know
 
 
 
Strongly Disagree Somewhat Disagree Neutral Somewhat Agree Strongly Agree N/A
service representatives are well trained. COMPANY
service representatives are well supervised. COMPANY
service representatives adhere to professional standards of conduct. COMPANY
service representatives act in my best interest. COMPANY
Overall, I am satisfied with the service representatives. COMPANY
 
 
 
About how long did you have to wait before speaking to a representative?
 
I was taken care of immediately
 
Within 3 minutes
 
3-5 minutes
 
5-10 minutes
 
More than 10 minutes
 
 
 
About how long did it take to get this problem resolved?
 
Immediate Resolution
 
Less than a day
 
Between 2 and 3 days
 
Between 3 and 5 days
 
More than a week
 
The problem is still not resolved
 
 

Very Satisfied Somewhat Satisfied Neutral Somewhat Dissatisfied Very Dissatisfied
Overall, how satisfied are you with the customer service experience?
 
 
In your opinion, how important is patient satisfaction within your organization?
 
It's a high priority
 
It's a mid-level priority
 
It's a low priority
 
Don't know
 
 
 
Does your organization have managers/staff dedicated to patient-satisfaction matters?
 
Yes
 
No
 
Don't know
 
 
 
Which one of the following means is used to evaluate patient satisfaction?
 
Questionnaires sent through the mail (in-house efforts)
 
Follow-up telephone calls (in-house efforts)
 
An outside firm has been hired to track patient satisfaction
 
Suggestion boxes placed in facilities
 
Other
 
 
 
What sector of the health care industry do you believe needs the most improvement in patient satisfaction?
 
Hospitals
 
Physicians
 
Managed-care plans
 
Insurers
 
Nursing homes
 
Outpatient providers
 
Other
 
 
 
What is the most compelling reason for your organization to improve customer satisfaction?
 
Fear of losing patients to competitors
 
Fear of losing employer contracts
 
Fear of increase regulation
 
Fear of damage to organization's reputation
 
Other
 
 
 
The process for getting your concerns resolved was:
 
Very Poor
 
Somewhat Unsatisfactory
 
About Average
 
Very Satisfactory
 
Superior
 
 
 
Would you please take a few minutes to describe what happened?
   
 
 
Customer Service Representative


The following questions pertain to the customer service representative you spoke with most recently. Please indicate whether you agree or disagree with the following statements
Strongly Agree Agree Neutral Disagree Strongly Disagree
The customer service representative was very courteous
The customer service representative handled my call quickly
The customer service representative was very knowledgeable
 
 
Are there any other comments about the customer service representative you would like to add?
   
 
 
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
 
 
 
Overall, how would you rate [COMPANY]?
 
Excellent
 
Good
 
Average
 
Poor
 
Terrible
 
Not Sure
 
 
 
How satisfied are you with your service from [COMPANY]?
 
Extremely satisfied
 
Very satisfied
 
Neutral
 
Very dissatisfied
 
Extremely dissatisfied
 
 
 
Please tell us how we could improve the quality of support we provide to you or your organization:
   
 
 
 
[COMPANY] understands the service needs of my organization.
 
Strongly agree
 
Agree
 
Neutral
 
Disagree
 
Strongly disagree
 
Not sure
 
 
 
Overall, how satisfied are you with the amount of contact between you/your organization and [COMPANY]?
 
Very satisfied
 
Satisfied
 
Neutral
 
Dissatisfied
 
Very dissatisfied
 
Not sure
 
Please contact [email protected] if you have any questions regarding this survey.
Survey Software Powered by QuestionPro Survey Software