DCH--How is Our Customer Service?
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1. We want to continue to improve....
...so we need your feedback. Please answer the following questions so we know how we are doing. If you see a question with an *, that means it has to be answered.
*
1
. I contacted DCH because I needed information on or from:
(Please choose all that apply.)
I contacted DCH because I needed information on or from: (Please choose all that apply.)
Medicaid or any of its programs
PeachCare for KidsTM
The State Health Benefit Plan (SHBP)
Health Planning
The Certificate of Need Program (CON)
Georgia Families
Fraud and Abuse
The Health Information Technology and Transparency Initiative (HITT)
The Office of Rural Health Services (ORHS)
The Office of Health Improvement (OHI)
Budget
The DCH Board
Grants and Requests for Proposal (RFPs)
Other
Other (please specify)
2
. If you contacted PeachCare for Kids TM, did you:
If you contacted PeachCare for Kids TM, did you:
Call the 1-877-GAPEACH number
Contact someone at the Georgia Department of Community Health
Both
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3
. Date of contact:
MM
DD
YYYY
Date:
Date of contact: Date: Month
/
Day
/
Year
*
4
. Type of contact:
Type of contact:
Phone
E-mail
Internet
*
5
. I am a :
I am a :
Member
Provider
Other
Other (please specify)
*
6
. Please rate the service you received today based on the following scale:
1 (Strongly Disagree) through 10 (Strongly Agree).
Please answer for each of the following statements:
1
2
3
4
5
6
7
8
9
10
We were courteous
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Please rate the service you received today based on the following scale: 1 (Strongly Disagree) through 10 (Strongly Agree). Please answer for each of the following statements: We were courteous 1
We were courteous 2
We were courteous 3
We were courteous 4
We were courteous 5
We were courteous 6
We were courteous 7
We were courteous 8
We were courteous 9
We were courteous 10
We were helpful
We were helpful 1
We were helpful 2
We were helpful 3
We were helpful 4
We were helpful 5
We were helpful 6
We were helpful 7
We were helpful 8
We were helpful 9
We were helpful 10
We were knowledgeable
We were knowledgeable 1
We were knowledgeable 2
We were knowledgeable 3
We were knowledgeable 4
We were knowledgeable 5
We were knowledgeable 6
We were knowledgeable 7
We were knowledgeable 8
We were knowledgeable 9
We were knowledgeable 10
We responded to you quickly
We responded to you quickly 1
We responded to you quickly 2
We responded to you quickly 3
We responded to you quickly 4
We responded to you quickly 5
We responded to you quickly 6
We responded to you quickly 7
We responded to you quickly 8
We responded to you quickly 9
We responded to you quickly 10
Even if we had to tell you "no," you were treated respectfully
Even if we had to tell you "no," you were treated respectfully 1
Even if we had to tell you "no," you were treated respectfully 2
Even if we had to tell you "no," you were treated respectfully 3
Even if we had to tell you "no," you were treated respectfully 4
Even if we had to tell you "no," you were treated respectfully 5
Even if we had to tell you "no," you were treated respectfully 6
Even if we had to tell you "no," you were treated respectfully 7
Even if we had to tell you "no," you were treated respectfully 8
Even if we had to tell you "no," you were treated respectfully 9
Even if we had to tell you "no," you were treated respectfully 10
Overall, I was satisfied with my contact with DCH
Overall, I was satisfied with my contact with DCH 1
Overall, I was satisfied with my contact with DCH 2
Overall, I was satisfied with my contact with DCH 3
Overall, I was satisfied with my contact with DCH 4
Overall, I was satisfied with my contact with DCH 5
Overall, I was satisfied with my contact with DCH 6
Overall, I was satisfied with my contact with DCH 7
Overall, I was satisfied with my contact with DCH 8
Overall, I was satisfied with my contact with DCH 9
Overall, I was satisfied with my contact with DCH 10
7
. Do you have a:
Do you have a:
Question
Comment
Compliment
Complaint
Your input:
8
. If you would like us to contact you, please provide us with:
If you would like us to contact you, please provide us with:
Your name
Phone number
E-mail address
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