Please answer each question with a response that closely answers your opinion. 

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* 1. I am treated with respect by the Tempus Unlimited PCM Staff.

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* 2. When I call Tempus Unlimited PCM with questions regarding my PCA services, my questions are answered correctly and timely.

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* 3. When I call Tempus Unlimited PCM and leave a message, my call is returned within 2 business days. 

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* 4. My skills trainer has kept scheduled appointments with me.

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* 5. My skills trainer has been helpful in teaching me how to manage the PCA program.

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* 6. Tempus Unlimited PCM worked with me to develop a Service Agreement

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* 7. The evaluation team who conducted my evaluation was professional and respectful.

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* 8. My evaluation was done in a timely manner

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* 9. My evaluation accurately reflects my need for physical assistance with personal care.

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* 10. I was given the opportunity to review my evaluation.

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* 11. My skills trainer explained the MassHealth appeals process to me

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* 12. I would recommend the PCM services at Tempus Unlimited to a friend.

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* 13. Overall I am satisfied with services provided by Tempus Unlimited PCM

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* 14. I understand that I cant bill when I am admitted to a hospital or rehab.

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* 15. I understand that I cant have the PCA program, Adult Foster Care, or Group Adult Foster Care at the same time. 

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* 16. I have been given a copy of the Tempus Unlimited PCM complaint and Grievance policy?

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* 17. I understand that I must submit PCA time sheets right after the end of the pay period.

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* 18. I have access to the internet?

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* 19. Additional comments and/or suggestions: 

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* 20. Are there any other services or activities that you think Tempus Unlimited PCM should be offering to consumers?

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* 21. What is your email address:

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* 22. What is your skills trainers name (optional):

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* 23. Your name:

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