Pike County Health Department, Home Health & Hospice Satisfaction Survey

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* 1. How likely is it that you would recommend this company to a friend or colleague?

Not at all likely

Extremely likely

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* 2. Overall, how satisfied or dissatisfied are you with our company?

Very satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Very dissatisfied

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* 3. Which of the following words would you use to describe our services? Select all that apply.

Reliable and Passionate

High quality

Caring

Unique

Poor quality

Unreliable

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* 4. How well do our services meet your needs?

Extremely well

Very well

Somewhat well

Not so well

Not at all well

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* 5. How would you rate the quality of the service?

Very high quality

High quality

Neither high nor low quality

Low quality

Very low quality

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* 6. How do you typically hear about us, our services, and our events?

Internet/Our Webpage

Word of mouth

Facebook

Newspaper

Radio

Other (please specify)

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* 7. How responsive have we been to your questions or concerns about our services?

Extremely responsive

Very responsive

Somewhat responsive

Not so responsive

Not at all responsive

Not applicable

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* 8. How long have you known about our company?

Less than six months

Six months to a year

1 - 2 years

3 or more years

this is my first time

How did you first hear about us?

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* 9. How likely are you to utilize our services again?

Extremely likely

Very likely

Somewhat likely

Not so likely

Not at all likely

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* 10. Leave a testimony: Please tell us how our services have effected yourself and/or your family. These answers will be used for marketing/publication purposes.

*CONTEST RULES
- Leave your Name and phone number in this section to be entered to win.
- Winner is picked at random.
- Your name will be automatically put into each following drawing until yours has been pulled.
- If you leave a your personal testimony on more than one of the services we offer, your name will be added again into the drawing for each additional testimony.
- Testimony's must be from personal experience with one or more of our services.
- Prize will be in the value of a $10 gift certificate to a local community business. Visit our Facebook page to follow the contest!