1. LHA Office Visit Survey

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* 1. What LHA office did you visit today?

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* 2. Did you receive friendly and courteous service at the reception desk during your visit today?

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* 3. How long did you have to wait before you were seen for your appointment/specific service today?

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* 4. If you had an appointment today, was the person seeing you prepared (example, i.e., forms ready and available for your review/signature, prompt meeting, ink pen available for your use, etc.)?

  Not Prepared Somewhat Prepared Well Prepared N/A
Promptness in meeting with you
Paperwork ready
Clean space to sit and desktop available for writing

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* 5. The person you met with today was friendly and courteous?

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* 6. If you came in today about a specific concern, was the issue resolved today?

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* 7. If your issue was not resolved today, did someone offer to call you or schedule another appointment with you to revisit the issue?

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* 8. Based on your visit today, do you feel that our service can be improved?

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* 9. If you had a problem during your visit today, would you like to be contacted by a supervisor?

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