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* 1. What is your gender?

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* 2. What city do you currently live in?

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* 3. How many people currently live in your household?'

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* 4. What is your total household income?

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* 5. Overall, how satisfied or dissatisfied were you with your last visit to Genesis Programs Inc?

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* 6. How easy or difficult was it to schedule an appointment at a time that was convenient for you?

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* 7. In your opinion, how convenient is the location of our Facility?

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* 8. Please indicate your level of satisfaction with the following items related to the Receptionist.

  Very satisfied Satisfied Neither satisfied nor dissatisfied  Dissatisfied Very Dissatisfied
Welcoming
Professionalism
Attentiveness 
Friendliness and Courtesy
Overall Customer Service Experience 

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* 9. How comfortable was the lobby and waiting area?

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* 10. Was your appointment with the Staff within the time frame originally quoted?

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* 11. How well did the Counselor listen to your needs?

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* 12. How well did the Counselor answer your questions?

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* 13. How well did the Counselor explain your treatment options?

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* 14. How satisfied were you with the Counselor explanation to your follow-up care?

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* 15. How much do you trust the recommendations of the Counselor?

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* 16. How satisfied or dissatisfied were you with the amount of time the Counselor spent with you addressing your needs?

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* 17. Overall, how would you rate the care you received from the Counselor?

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* 18. How likely is it that you would recommend our Treatment Program to a friend or family member?

NOT AT ALL LIKELY
EXTREMELY LIKELY

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* 19. Is there anything we could have done to improve your last visit?

0 of 19 answered
 

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