2014 Q1-Q2 Client Satisfaction Survey Please respond to the following questions by checking the box that best fits your response. Question Title * 1. DATE Question Title * 2. REGION MN - Central MN - North MN - South IL - Quad Cities IL - Peoria Question Title * 3. (optional) Client Name: Question Title * 4. Accurate Home Care provides me with quality care Always Often Seldom Never Question Title * 5. Accurate Home Care field staff are courteous Always Often Seldom Never Question Title * 6. Accurate Home Care office staff are courteous Always Often Seldom Never Question Title * 7. Accurate Home Care staff is dependable Always Often Seldom Never Question Title * 8. I feel safe while under the care of an Accurate Home Care staff member. Always Often Seldom Never If you did not answer 'Always' please explain Question Title * 9. I am able to reach Accurate Home Care Customer Service when I need them Always Often Seldom Never Question Title * 10. I am able to reach an Accurate Home Care Clinical Manager when I need them Always Often Seldom Never Question Title * 11. I am able to reach an Accurate Home Care Staffer when I need them Always Often Seldom Never Question Title * 12. I am able to reach billing at Accurate Home Care Always Often Seldom Never Question Title * 13. Accurate Home Care staff addresses my questions and concerns Always Often Seldom Never Question Title * 14. What would you like Accurate Home Care to keep doing? Question Title * 15. What would you like Accurate Home Care to stop doing? Done