Referral Source Satisfaction Survey



    Thank you for the opportunity of referring consumers to our organization recently. Please take a few moments to rate the following so that we may continue to improve our services. All surveys are confidential.

    Follow up contact will be made within one week of you receiving this survey, if we have not received a response from you.

    CHECK ONLY ONE ANSWER

    Excellent

    Good

    Average

    Poor

    N/A

    1. Staff returned my call within 24 hours?

    ExcellentGoodAveragePoorN/A

    2. Staff was courteous, professional and helpful?

    ExcellentGoodAveragePoorN/A

    3. Availability of staff

    ExcellentGoodAveragePoorN/A

    4. Turn around time from phone call to appointment

    ExcellentGoodAveragePoorN/A

    5. Response time of disposition of consumer

    ExcellentGoodAveragePoorN/A

    6. Protection of consumer’s privacy/confidentiality

    ExcellentGoodAveragePoorN/A

    7. Possibility of future referrals to FWC

    ExcellentGoodAveragePoorN/A

    8. Possibility of recommending us to another agency

    ExcellentGoodAveragePoorN/A

    9. How would you rate our quality of service?

    ExcellentGoodAveragePoorN/A

    10. In an overall, general sense, how would you rate your experience with the referral process?

    ExcellentGoodAveragePoorN/A

    Contact us to schedule an appointment.

    Contact Us

    3883 Rogers Bridge Road, Suite 202A, Duluth GA. 30097, U.S.A
    View Map & Directions »

    Phone Number: +1 (770) 545 8359
    Fax Number: (229)-515-4233
    info@familywellnesscenterllc.com