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Dean On Call Survey
Thinking about your most recent call to "Dean on Call", please respond to the following:
1. Month of call:
1. Month of call:
Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Nov
Dec
2. Your Gender
2. Your Gender
Male
Female
3. Your Age
3. Your Age
0-24
25-34
35-44
45-54
55-64
65+
4. Have you previously used Dean on Call Services?
4. Have you previously used Dean on Call Services?
Yes
No
5. When you called "Dean on Call", did you reach the nurse right away?
5. When you called "Dean on Call", did you reach the nurse right away?
Yes
No
6. If you left a message, did you get a call back from the nurse in:
6. If you left a message, did you get a call back from the nurse in:
less than 15 minutes
15-30 minutes
greater than 30 minutes
7. Please rate your overall satisfaction with the telephone encounter you had with the "Dean On Call" nurse? (consider the knowledge of the nurse, was he/she able to understand what your concern was, and the comfort level with talking to the nurse)
7. Please rate your overall satisfaction with the telephone encounter you had with the "Dean On Call" nurse? (consider the knowledge of the nurse, was he/she able to understand what your concern was, and the comfort level with talking to the nurse)
Excellent
Very Good
Good
Fair
Poor
Please Comment:
8. What was the outcome of your call to "Dean On Call"?
8. What was the outcome of your call to "Dean On Call"?
The nurse recommended obtaining care
The nurse was able to help me over the phone
Not Applicable
9. Did you follow the nurse's recommendation?
9. Did you follow the nurse's recommendation?
Yes
No
If no, please indicate why:
10. How did you hear about "Dean on Call"? (Check all that apply)
10. How did you hear about "Dean on Call"? (Check all that apply)
Brochure/Magnet/Sticker
Media (TV/Radio/Billboard/Newspaper/Telephone Book)Insurance Card/Insurance Newsletter
Recommended:(Your Doctor or nurse/Hospital Discharge Information/Family or Friend)
DeanCare.com
Other (please specify)
11. Would you recommend this service to family/friends?
11. Would you recommend this service to family/friends?
Yes
No
12. Comments: (Please tell us if there is anything we could do to improve our service)
12. Comments: (Please tell us if there is anything we could do to improve our service)
Thank you for your time.
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