Post-Visit Client Satisfaction Survey
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I was greeted courteously and treated professionally.
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Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree
I felt listened to and understood by staff.
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Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree
My questions were answered to my satisfaction.
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Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree
I felt that staff were helpful and cooperative.
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Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree
My plan is working for me.
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Strongly Agree
Agree
Neither Agree or Disagree
Disagree
Strongly Disagree
May we contact you for follow-up about your answers to this survey?
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Yes
No
Name
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First
Last
Email
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Comments
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