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Customer Survey
Thank you for calling or visiting South Plains Rural Health. Please share your feedback by filling in the information below. We value your business and suggestions.
Date of Visit/Call (MM/DD/YYYY)
*
Time of Visit/Call
*
Morning
Afternoon
Evening
Night
Briefly describe your experience on your visit or call to South Plains Rural Health.
*
About long did you wait to see or speak with someone at SPRHS?
*
I was helped immediately
1-3 minutes
3-9 minutes
9-20 minutes
More than 20 minutes
(For callers only) From the time you first spoke with the representative, how long did it take to resolve the issue?
It was resolved immediately
Less than a day
1-2 days
3-5 days
More than 5 days
The issue is still unresolved
Please indicate which department you visited/called.
*
Medical
Dental
Vision
Pharmacy
Lab
If your call had to be transfered to another representative or department, were you transfered correctly on the first try?
Yes
No
Please evaluate the staff at SPRHS.
*
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Eager to help
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Knowledgeable
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Polite
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Spoke clearly
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Understood my issue
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
How many calls or visits to our office did you have to make to resolve your condition.
1
2
3
4 or more
The issue is still unresolved
Overall, how satisfied were you with our staff at SPRHS?
*
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Comments
First Name
Last Name
Address 1
Address 2
City
State
Postal Code
Phone
Email Address