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Patient Satisfaction Survey

We're Listening!
As Vice-President of Operations, I want to thank you for giving us the opportunity to service your laboratory needs. Please help us to continue improving our service by completing our brief survey.

Thank you for selecting CompuNet Clinical Laboratories!

Paul
Paul Labbe


CompuNet Clinical Laboratories Patient Satisfaction Survey

Your Name:
Date Of Visit:
Location:

1 - Comfort/Cleanliness of Facility:
5 - Very Good
4 - Good
3 - Fair
2 - Poor
1 - Very Poor
 
2 - Did the staff treat you in courteous, professional manner?
5 - Very Good
4 - Good
3 - Fair
2 - Poor
1 - Very Poor
 
3 - Name of Phlebotomist (staff member drawing your blood):
 
4 - Skill of phlebotomist collecting specimen:
5 - Very Good
4 - Good
3 - Fair
2 - Poor
1 - Very Poor
 
5 - Did the Phlebotomist wear gloves while drawing your blood?
Yes No
 
6 - Did the Phlebotomist wear a lab coat while drawing your blood?
Yes No
 
7 - How long did you wait to be served?
0-10 Minutes
11-20 Minutes
21-30 Minutes
30+ Minutes
 
8 - What was the overall level of care you received during your visit?
5 - Very Good
4 - Good
3 - Fair
2 - Poor
1 - Very Poor
 
9 - Would you recommend CompuNet Clinical Laboratories to a family member or friend?
Yes No
 
10 - Would you like a return call concerning your visit?
Yes No
   
Name:
Phone:
Comments Or
Suggestions:
CLIENT SERVICES
We are also available to answer any questions you may have.

Telephone (937) 297-8260.
Outside Dayton, but within Ohio: 1-800-686-2252.