Employee Occupational Health Department (EOHD) Customer Satisfaction Survey

Question Title

* 1. At which Employee Occupational Health Department (EOHD) location did you receive services?

Sharp Metropolitan Medical Campus (Knollwood)

Spectrum

Grossmont

Chula Vista

Coronado

Non-EOHD locations

Question Title

* 2. What was the reason for your visit?

New Employee Physical

TB / Annual Screening

Work Injury or Exposure

SNF Physical

Flu Vaccine

Other

Question Title

* 3. Were you offered an Employee Wellness screening (blood pressure, cholesterol, blood sugar, BMI and tobacco use). Complete this question if your visit was for New Employee Physical, TB / Annual or SNF Physical. Select N/A for any other visit.

Yes

No

N/A

Question Title

* 4. How well did the EOHD team perform AIDET?

	Excellent	Average	Poor
Acknowledge	Acknowledge Excellent	Acknowledge Average	Acknowledge Poor
Introduce	Introduce Excellent	Introduce Average	Introduce Poor
Duration	Duration Excellent	Duration Average	Duration Poor
Explain	Explain Excellent	Explain Average	Explain Poor
Thank You	Thank You Excellent	Thank You Average	Thank You Poor

Question Title

* 5. Overall, how satisfied or dissatisfied are you with the services you received in EOHD?

Very satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Very dissatisfied

Question Title

* 6. Do you have any other comments, questions, or concerns?