Practice Details:

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* 1. Practice Name

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* 2. Full Address

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* 3. Clinical Specialty

Your Details:

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* 4. Name:

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* 5. Position in practice:

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* 6. Email Address:

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* 7. Phone Number:

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* 8. Account Number:

Please rate satisfaction for each question below, based on 1 being not satisfied to 10 being very satisfied.

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* 9. On a scale of 1 (Not at all likely ) to 10 (Extremely likely), how likely are you to recommend our services to a friend or colleague?

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* 10. How satisfied are you with Phlebotomy services?

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* 11. How satisfied are you with our Courier Services?

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* 12. How satisfied are you with the ability to reach Customer Services?

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* 13. How would you rate the laboratory turnaround time and testing quality?

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* 14. How satisfied are you with report clarity and accuracy?

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* 15. How satisfied are you with hardware solutions to include EMR interface and printers?

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* 16. How satisfied are you with the availability of consulting services with Pathology staff?

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* 17. How satisfied are you with your Account Representative?

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* 18. How satisfied are you with timeliness of billing question resolution?

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* 19. How do your patients rate their laboratory service with our company?

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* 20. Do you have any additional comments you would like to make?

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