Medical Records Survey

Customer Service Survey Health Information Management Services
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Customer Service Survey Health Information Management Services

We are conducting a satisfaction survey to learn what is important to our customers. We appreciate your feedback.

INSTRUCTIONS: Check the box that best describes your experience.
What was the nature of your contact with us?
Calendar
Questionnaire
QuestionnaireStrongly AgreeAgreeDisagreeStrongly DisagreeNo Comment or N/A
1. Staff was courteous and helpful.
2. Staff provided complete, accurate information.
3. A timely response was provided.
4. My overall experience was positive.
Please complete the section below if your contact with us involved Release of Information
Please complete the section below if your contact with us involved Release of InformationStrongly AgreeAgreeDisagreeStrongly DisagreeNo Comment or N/A
5. A representative returned my call within 24 business hours.
6. I was informed of the timeline/cost of my request for records.
7. The representative expressed concerns for privacy/confidentiality of my record.
8. I received all of the documents that I requested.
9. The process to obtain medical records was uncomplicated.
If you still have a concern about our services, please consider giving us another chance to resolve it. Please complete the information below and someone will contact you.
If you still have a concern about our services, please consider giving us another chance to resolve it. Please complete the information below and someone will contact you.Contact Info
Name:
Telephone number: