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Customer name:

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Provider or staff member name:

Please provide your responses to each of the following questions on a scale of 1 to 5, with 5 being Excellent, 3 being Good, and 1 being Poor.  We welcome any additional Comments.

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1. Your overall experience with ESCL?

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2. Quality of Test Results?

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3. General Turnaround Time of Results?

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4. Professionalism of Client Services staff?

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5. Overall satisfaction of Phlebotomy Staff?  (Patient feedback re: Patient Service Centers)

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