Rhema Healthcare - Customer Service Evaluation Form
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1. Are you filling in this evaluation form for?
*
Myself
Spouse or Partner
Child
Relative
Friend
Client
2. Overall, please rate the quality of service you received.
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Very Good
Good
Neutral
Poor
Very Poor
3. Was the nurse on time for the assessment?
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Yes
No
4. Did the nurse address your questions or concerns to your satisfaction during or after the assessment?
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Yes
No
5. How knowledgeable was the nurse who assisted you?
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Extremely knowledgeable
Very knowledgeable
Somewhat knowledgeable
A little knowledgeable
Not at all knowledgeable
6. How would you rate our respect for your privacy?
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Outstanding
Good
Needs Imporvement
Poor
7. Please rate the speed of our services
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Very Good
Good
Neutral
Poor
Very Poor
8. Would you recommend our services to others?
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Definitely
Maybe
No
Submit