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GHS Feedback Survey
GHS Feedback Survey
How satisfied were you with the following: (Scale from Very Satisfied to Dissatisfied)
Ease of contacting GHS
Very Satisfied
Somewhat Satisfied
Satisfied
Somewhat Dissatisfied
Very Dissatisfied
Communication/updates from the GHS team
Very Satisfied
Somewhat Satisfied
Satisfied
Somewhat Dissatisfied
Very Dissatisfied
Ease of working with the GHS patient coordinator
Very Satisfied
Somewhat Satisfied
Satisfied
Somewhat Dissatisfied
Very Dissatisfied
Not Applicable
Ease of working with the GHS nurse navigator
Very Satisfied
Somewhat Satisfied
Satisfied
Somewhat Dissatisfied
Very Dissatisfied
Not Applicable
Ease of working with the GHS financial coordinator
Very Satisfied
Somewhat Satisfied
Satisfied
Somewhat Dissatisfied
Very Dissatisfied
Not Applicable
Post-visit follow up/coordination
Very Satisfied
Somewhat Satisfied
Satisfied
Somewhat Dissatisfied
Very Dissatisfied
Please answer yes or no to the following questions.
Would you use GHS in the future for your patients?
Yes
No
Would you recommend GHS to your colleagues?
Yes
No
Additional Information
Comments/Kudos
Name (First and Last):
Phone:
Email Address:
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