Access HealthONE Customer Satisfaction Survey

* 1. How professional were the Access HealthONE Nurse and EMT Communications Specialists?

Extremely Professional

Professional

Fairly Professional

Never Professional

Not Applicable

* 2. Did you find the Access HealthONE Nurse and EMT Communications Specialists knowledgeable about the admission and transfer process?

Extremely Professional

Professional

Fairly Professional

Never Professional

Not Applicable

* 3. Did using Access HealthONE improve your patients' experiences by expediting admission, transfer, or transport?

Greatly Improved

Improved

Fairly Improved

Not Improved

Not Applicable

* 4. Did using the services provided by Access HealthONE ease the admission and transfer process to HealthONE facilities for you and your staff?

Greatly Improved

Improved

Fairly Improved

Not Improved

Not Applicable

* 5. Did the Access HealthONE services meet your expectations?

Excellent

Very Good

Good

Fair

Poor

* 6. Were your requests handled timely?

Extremely Timely

Timely

Fairly Timely

Not Timely

Not Applicable

* 7. For which service did you receive assistance in the question above?

Transfer

Admission

Consult

* 8. Do you have recommendations for Access HealthONE to improve services or any comments regarding a question listed above?

* 9. Are you a ...

HealthONE Provider

Local Provider (Denver area, to include Greeley and Fort Collins)

Regional Provider (outside the Denver area)

* 10. Please provide contact information if you would like to be contacted regarding any questions, comments, or concerns.

Name:

Company:

Email Address:

Phone Number: