Customer Satisfaction Survey
Customer name:
(Required.)
Provider or staff member name:
(Required.)
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.
1. Your overall experience with ESCL?
5
4
3
2
1
Comments:
2. Quality of Test Results?
5
4
3
2
1
Comments:
3. General Turnaround Time of Results?
5
4
3
2
1
Comments:
4. Professionalism of Client Services staff?
5
4
3
2
1
Comments:
5. Overall satisfaction of Phlebotomy Staff? (Patient feedback re: Patient Service Centers)
5
4
3
2
1
Comments:
