Referring Agency Satisfaction Survey

The experience our partners have with our Mobile Integrated Healthcare programs is important to us and it helps us make the programs even more effective.

Please take a moment to tell us about your experience by answering a few quick questions about your experience.

Program Referral Type (required)

Referring Agency Type (required)

On a scale of 1-5, with 5 being the best, how would you rate the ease of making the referral?

The efficiency of the referral process?

The response time of the MedStar Medic?

The Communication skills of the responding MedStar Medic?

The feedback or follow-up provided to you about your patient.

The professionalism of the responding Medic?

How would you rate your overall satisfaction that the patient's needs were met by the MedStar MIH program?

How was your overall satisfaction with the referral process?

How was your overall satisfaction with our service?

Would you recommend this service to others?

Is there any way we can improve our service to you or the patient?

Please leave this field empty.

Referring Agency Satisfaction Survey

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