Client Satisfaction SurveyKyle Henderson2017-09-28T14:37:42-05:00 We at GC Health Services, Inc. desire to provide the best Home Health Services possible to our Clients. To do so we need your help. We rely on our clients to keep us informed about what we are doing right and what needs improvement. We are interested in rendering quality care to our clients and would appreciate your input by answering the following questions. Your evaluation will allow us to be more responsive to future client/family needs. Please complete the following survey after the first Recertification Period. Rate our ServicesDoes the nurse come to work early?*YesPartlyNoDid the nurse(s) do a professional work?*YesPartlyNoRate nurse(s)*PoorFairGoodVery GoodExcellentAre you happy with the services rendered?*YesPartlyNoWould you recommend GC Health Services to others?*YesPartlyNoRate our Home Care StaffHow would you rate the services you received from GC Health Services?*PoorFairGoodVery GoodExcellentHow would you rate our ability to answer your questions when calling our office?*PoorFairGoodVery GoodExcellentPediatric Care*PoorFairGoodVery GoodExcellentService not ApplicableAdult Care*PoorFairGoodVery GoodExcellentService not ApplicablePhysical Therapy*PoorFairGoodVery GoodExcellentService not ApplicableOccupational Therapy*PoorFairGoodVery GoodExcellentService not ApplicableSpeech Therapy*PoorFairGoodVery GoodExcellentService not ApplicablePersonal Care Attendant*PoorFairGoodVery GoodExcellentService not ApplicableIf home health care services were needed again, would you use GC Health Services?*YesNoOverall satisfaction with GC Health Services?*PoorFairGoodVery GoodExcellentDid you participate in your plan of care?*YesNoDid you receive and understand your "Bill of Rights" including the toll free "Hotline" number that you could call if any problems were not resolved by the Agency?*YesNoDid the staff visit as frequently as they stated they would when they started your services?*YesNoWere you comfortable asking staff about your health?*YesNoDid the staff person visit at a mutually agreeable time?*YesNoDid you feel that you were discharged appropriately?*YesNoWould you use the services of the Agency in the future?*YesNoIf not, why?Suggestions for improvement.I received care from: SN (Skilled Nursing) PT (Physical Therapy) OT (Occupational Therapy) ST (Speech Therapy) MSW (Medical Social Worker) HME (Health Medical Equipment) HHA (Home Health Aide) Office Record #Contact InfoPatient's Name*Patient NumberIf knownSurvey Completed by*Client/PatientSomeone ElseYour Name*Your Email* Relationship to Patient*PhonePlease contact meAs soon as possibleImmediatelyPhoneThis field is for validation purposes and should be left unchanged.
