Client Satisfaction Survey
Exit this survey 

1. Default Section

 
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1. My medical providers, nurses and other clinics staff treat me with respect and dignity.
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2. I feel my care and personal information are protected and kept confidential.
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3. I trust that my medical providers can take care of my needs and answer my concerns.
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4. I can obtain appointments that are convenient me.
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5. I have a chance to ask questions; EIS staff listens to me and I receive answers I can understand.
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6. Referrals to other providers/specialists outside of the EIS Program are well coordinated.
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7. I feel my HIV/AIDS care is well coordinated with other providers and specialists I see.
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8. If I choose, my other care givers (family, partners, friends and support organizations) have the oppurtunity to participate in my EIS Program care plan.
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9. I am encouraged to participate in my healthcare; my care and treatments are explained to me.
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10. I receive and understand instructions and training for my medications.
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11. Please rate the services that you receive from the EIS Program
LowBelow AverageAverageAbove AverageHigh
I rate the care and services I receive
12. Please tell us what suggestions you have to improve care and services for EIS patients