OCCUPATIONAL MEDICINE CONSULTANTS Customer Satisfaction Questionnaire

OCCUPATIONAL MEDICINE CONSULTANTS
Customer Satisfaction Questionnaire
March 2015

Please rate your overall experience with OMC

Excellent

Very Good

Good

Fair

Poor

Please rate the cleanliness and professional appearance of the waiting area

Excellent

Very Good

Good

Fair

Poor

Please rate the reception you received

Excellent

Diane Sawyer

Dolly Darton

Rosann Barr

You felt like:

An important guest

A close relative/friend

A troublesome child

Staff greeted you with a smile and addressed you by name

Excellent

Very Good

Good

Fair

Poor

Knowledge and efficiency in assisting you

Excellent

Very Good

Good

Too busy

Frazzeled

Overall courtesy and helpfulness

Excellent

Very Good

Good

Indifferent

Experience with the physician

Marcus Welby

Hawkeye

Star Trek Bones

A Board Certified Occupational Physician

Barney Fife

Did you receive instructions for follow up care that were clear and concise?

Excellent

Very Good

Good

Fair

Poor

Additional comments/suggestions which will enable us to better serve you needs.

THIS IS A CUSTOMER SURVEY DESIGNED TO HELP US TO BETTER SERVE YOU IN THE FUTURE.

IT IS NOT A FORM FOR SUBMITTING QUESTIONS OR COMPLAINTS. IF YOU WOULD LIKE A RESPONSE TO ANY COMMENT PLEASE CONTACT US ON OUR WEBSITE @ www.occumedonline.com

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