CBM Pathology Services Client Survey Question Title * 1. Contact Information: Name * Practice * Address * Address 2 City/Town * State/Province * ZIP/Postal Code * Email Address * Phone Number * Question Title * 2. Overall, how satisfied are you with our services? Very Satisfied Somewhat Satisfied Neither Satisfied or Dissatisfied Somewhat Dissatisfied Very Dissatisfied Are there specific areas in which you are satisfied or dissatisfied? Question Title * 3. Overall, how satisfied are you with the interpretation of your pathology reports? Very Satisfied Somewhat Satisfied Neither Satisfied or Dissatisfied Somewhat Dissatisfied Very Dissatisfied Are there specific areas in which you are satisfied or dissatisfied? Question Title * 4. When you call CBM Pathology, are the pathologists available for consultation? Always Sometimes Seldom N/A Please comment on your experience. Question Title * 5. Do you receive your reports in a timely fashion? Yes No Please explain areas in which you have concerns. Question Title * 6. How would you rate our Customer Service? Very Satisfied Somewhat Satisfied Neither Satisfied or Dissatisfied Somewhat Dissatisfied Very Dissatisfied Polite and Professional Polite and Professional Very Satisfied Polite and Professional Somewhat Satisfied Polite and Professional Neither Satisfied or Dissatisfied Polite and Professional Somewhat Dissatisfied Polite and Professional Very Dissatisfied Knowledgeable Knowledgeable Very Satisfied Knowledgeable Somewhat Satisfied Knowledgeable Neither Satisfied or Dissatisfied Knowledgeable Somewhat Dissatisfied Knowledgeable Very Dissatisfied Able to Solve Problems Able to Solve Problems Very Satisfied Able to Solve Problems Somewhat Satisfied Able to Solve Problems Neither Satisfied or Dissatisfied Able to Solve Problems Somewhat Dissatisfied Able to Solve Problems Very Dissatisfied Are there specific areas in which you are satisfied or dissatisfied? Question Title * 7. When you contact our Billing Department are you satisfied with the help and information you receive? Yes No Please share your experience. Question Title * 8. How would you rate our courier service? Very Satisfied Somewhat Satisfied Neither Satisfied or Dissatisfied Somewhat Dissatisfied Very Dissatisfied Are there specific areas in which you are satisfied or dissatisfied? Question Title * 9. What changes could we make to better serve you, your staff, and your patients? Question Title * 10. Would you like a representative to contact you to address an immediate issue? Yes No Question Title * 11. Do we have your permission to use your comments and Practice name on our website? Yes No Done