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The Iowa Poison Control Center (IPCC) is always seeking ways to improve our services. If you have called the IPCC, please take a moment to complete the survey below. We value your feedback and carefully consider your opinions as we strive to exceed your expectations.

 The Iowa Poison Control Center (IPCC) is always seeking ways to improve our services. If you have called the IPCC, please take a moment to complete the survey below. We value your feedback and carefully consider your opinions as we strive to exceed your expectations.

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* 1. What is the approximate date of your call to the Iowa Poison Control Center?

Date:

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* 2. What is your zip code?

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* 3. Please answer the following questions using the rating system:

  Poor Average Good Excellent
Was your call answered promptly?
Was your specialist friendly and courteous?
Did the specialist seem knowledgeable?
Were the instructions easy to understand?

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* 4. Were you offered a FREE poison prevention packet?

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* 5. It is widely acknowledged that poison centers save money by reducing the unnecessary use of more costly health care resources. In an effort to demonstrate the effectiveness of the IPCC in controlling health care costs in Iowa, please answer the next two questions. All of your answers will be kept confidential. If you have any questions, please contact the Iowa Poison Control Center at 1-800-222-1222.

Do you consent to participating in the cost analysis survey?

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* 6. What would you have done if the Poison Center were not available?

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* 7. What type of health insurance do you have for the patient?  Mark all that apply for the patient

  Type of Health Insurance:
Private Insurance
State Medical Assistance
No Medical Coverage
Unknown Coverage

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* 8. May we contact you regarding your experience?

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* 9. Do you have any further comments or suggestions on how we can improve our services?

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