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* 1. Date Completed:

Date

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* 2. Please indicate which JVHL  Network Laboratory services your office:

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* 3. Why does your practice use this laboratory? (check all that apply)

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* 4. Please rate our services.

  Strongly Agree Agree Disagree Strongly Disagree Not Applicable (N/A)
Test results received are accurate, complete and timely.
Laboratory staff (client services) are professional and helpful whenever I require assistance.
A lab representative contacts my office on regular basis.
Courier services are professional and adhere to the scheduled pickup times.
Laboratory supply orders are accurately filled and arrive timely.
A Pathologist is available when I require a consultation.
STAT services, when needed, are satisfactory.
Electronic test order entry and result access is easy and convenient.
Overall, I am satisfied with the lab's services.
I would recommend this lab to my colleagues.

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* 5. Recommendations to improve service levels are:

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* 6. Would you like to speak with a laboratory representative about the services you have received?

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* 7. Please provide your name, email address, and phone number.

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