Client Satisfaction Quarterly Report

Tally Satisfaction Survey Result Quarterly Below

Statement
I received adequate information and was given printed information about my rights and responsibilities while receiving skilled nursing services, including how to voice a complaint.
All who provided services to me treated me with respect and courtesy.
Everyone that visited me provided good care.
The staff carried out assigned duties effectively and related well with me.
I feel the number of hours of services were sufficient for my needs.
Overall, I was satisfied with the services I received.
Excellent
Good
Average
Fair
Poor
N/A
Would you recommend our agency to other individuals or request our services again?
Any comments or suggestions:
Pt or Caregiver Name (Optional)

Date:

PAS Client Satisfaction Survey
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