CUSTOMER SATISFACTION SURVEY

Thank you for helping us serve you better!

Federal Occupational Health values your feedback about how well we are doing our job and what we can do to improve the services we deliver to you.  Please take a few moments to evaluate our services by answering the questions below.  Then electronically submit your answers by pressing the "submit" button at the end of the survey.  Your feedback will remain anonymous unless you provide contact information, which is strictly voluntary.


Occupational Health Center

calendar

Agency

* Please select your employing agency:

Service

* Purpose of Visit

Rating

Using a scale of 1 to 5 (1=unacceptable, 2=poor, 3=fair, 4=good, 5=excellent, and N/A=NOT APPLICABLE), please rate the following aspect of the service(s) you received on that date:
* 1. Flexibility in scheduling an appointment
Using a scale of 1 to 5 (1=unacceptable, 2=poor, 3=fair, 4=good, 5=excellent, and N/A=NOT APPLICABLE), please rate the following aspect of the service(s) you received on that date:
* 2. Prompt attention upon arrival
Using a scale of 1 to 5 (1=unacceptable, 2=poor, 3=fair, 4=good, 5=excellent, and N/A=NOT APPLICABLE), please rate the following aspect of the service(s) you received on that date:
* 3. Courteousness of staff
Using a scale of 1 to 5 (1=unacceptable, 2=poor, 3=fair, 4=good, 5=excellent, and N/A=NOT APPLICABLE), please rate the following aspect of the service(s) you received on that date:
* 4. Explanation of procedure
Using a scale of 1 to 5 (1=unacceptable, 2=poor, 3=fair, 4=good, 5=excellent, and N/A=NOT APPLICABLE), please rate the following aspect of the service(s) you received on that date:
* 5. Thoroughness of service
Using a scale of 1 to 5 (1=unacceptable, 2=poor, 3=fair, 4=good, 5=excellent, and N/A=NOT APPLICABLE), please rate the following aspect of the service(s) you received on that date:
* 6. Privacy/confidentiality of environment
Using a scale of 1 to 5 (1=unacceptable, 2=poor, 3=fair, 4=good, 5=excellent, and N/A=NOT APPLICABLE), please rate the following aspect of the service(s) you received on that date:
* 7. Explanation of results/answers to your questions
Using a scale of 1 to 5 (1=unacceptable, 2=poor, 3=fair, 4=good, 5=excellent, and N/A=NOT APPLICABLE), please rate the following aspect of the service(s) you received on that date:
* 8. Clarity on follow-up actions to take
Using a scale of 1 to 5 (1=unacceptable, 2=poor, 3=fair, 4=good, 5=excellent, and N/A=NOT APPLICABLE), please rate the following aspect of the service(s) you received on that date:
* 9. Helpfulness of educational /informational brochures
Using a scale of 1 to 5 (1=unacceptable, 2=poor, 3=fair, 4=good, 5=excellent, and N/A=NOT APPLICABLE), please rate the following aspect of the service(s) you received on that date:
* 10. Overall quality of our services

* Did we respond to your request for an appointment/service within 24 hours?



Please press the submit button to submit your answers.
* Indicates Response Required