Satisfaction Survey
To help us maintain the highest quality of care to our patients, we would appreciate your response to the following questions. 
   
 
* 1. Helpfulness of the person who answered the phone during the day

 
* 2. Helpfulness of the person who answered the phone after hours and on weekends and holidays

 
* 3. How well office staff handled your request to change nurse or aide

 
* 4. How well the RN Case Manager informed you about your care plan/services you were to receive

 
* 5. How well billing and payment questions were handled

 
* 6. How well office staff delt with problems and complaints

 
* 7. Friendliness of the aides that visited you

 
* 8. Degree of involvement you and your family have had in planning your home care

 
* 9. Aides concern for your comfort while treating or caring for you

 
* 10. Helpfulness of the person who coordinated your services

 
* 11. How well do the services provided by Atlantic Private Care Services meet your expectations for the care you feel you need?

 
* 12. How well has APCS addressed your safety needs in the home?

 
* 13. How concerned is Atlantic Private Care Services staff regarding your need(s) for privacy?

 
* 14. How well were the explanations regarding your financial liability explained to you?

 
* 15. How well did Atlantic Private Care Services staff explain the complaint procedure to you?

 
* 16. How well would you rate the care provided by the physical therapist

 
* 17. Skill of the nurses who cared for you

 
* 18. Friendliness of the nurses who visited you

 
* 19. What is the likelihood you will refer others to use the services of Atlantic Private Care Services?

 
* Who completed this Survey?

 
Patient’s Name: (Optional)

 
* Months/Years on Service

 
What can Atlantic Private Care Services do to increase patient safety?

 
Additional Comments:

 


Submit Survey    
   

Atlantic Private Care Services 
is a member of the 
following organizations:
 

Atlantic Private Care Services 
 is accredited by the 
following organizations:
 
Privacy Statement | Terms Of Use
Copyright 2009 Atlantic Private Care