AccentCare Referral Sources
At AccentCare we value your feedback on our services. We believe listening to our customers will make us a better homecare agency. Thank you for your valuable time in completing our on line survey.
Sincerely;
Jeff Hammond
Vice President of Sales
I refer patients to AccentCare from a?
Hospital
Skilled Nursing Facility
Assisted Living Facility
Physicians Office
Other
If you would like to provide AccentCare with your contact information please complete the area below:
Name
Facility
City
Phone number
E-mail
My most recent referral to AccentCare was for?
Home Health Services (RN, PT, OT)
Home Care / Companion Services
Home Infusion Services
How long had you been on hold before someone helped you?
I was never on hold
Less than a minute
1 to 2 minutes
2 to 5 minutes
More than 5 minutes
Not sure
How efficiently was your request handled?
Very efficiently
Somewhat efficiently
Not efficiently
Not yet resolved
How would you rate our staff's level of professionalism?
Please select one ...
Excellent
Very Good
Good
Fair
Poor
For how long have you used our service?
Under 1 month
1 - 6 months
6 months - 1 year
1 - 3 years
Over 3 years
Never Used
Overall, how satisfied were you with our service?
Satisfied
Somewhat Satisfied
Neutral
Somewhat Dissatisfied
Dissatisfied
How does our service compare with average service you have experienced with other organizations?
Much better than average
Somewhat better than average
About the same average
Much worse than average
Somewhat worse than average
Please tell us how we might better serve you in the future.