Anonymous Patient Satisfaction Survey

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Anonymous Patient Satisfaction Survey

Anonymous Patient Satisfaction Survey

HIPAA

Compliance

1
How was your most recent order with Cascade placed?* This field is required.
Phone
Treatment Center
MyChart
Other
2
Please rate the following: Our Staff
Excellent
Very Good
Good
Fair
Poor
Not Applicable
Courtesy and respectfulness
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Helpfulness with placing an order
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Helpfulness with billing or insurance
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Courtesy and respectfulness
Helpfulness with placing an order
Helpfulness with billing or insurance
Excellent
Row 0, Column 0
Very Good
Row 0, Column 1
Good
Row 0, Column 2
Fair
Row 0, Column 3
Poor
Row 0, Column 4
Not Applicable
Row 0, Column 5
Excellent
Row 1, Column 0
Very Good
Row 1, Column 1
Good
Row 1, Column 2
Fair
Row 1, Column 3
Poor
Row 1, Column 4
Not Applicable
Row 1, Column 5
Excellent
Row 2, Column 0
Very Good
Row 2, Column 1
Good
Row 2, Column 2
Fair
Row 2, Column 3
Poor
Row 2, Column 4
Not Applicable
Row 2, Column 5
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3
Please rate the following: Our Communication With You
Excellent
Very Good
Good
Fair
Poor
Not Applicable
Phone calls are answered promptly
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Ability to contact Cascade staff after hours
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Phone calls are returned in a timely manner
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Complaints/concerns are addressed promptly
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Row 3, Column 5
Phone calls are answered promptly
Ability to contact Cascade staff after hours
Phone calls are returned in a timely manner
Complaints/concerns are addressed promptly
Excellent
Row 0, Column 0
Very Good
Row 0, Column 1
Good
Row 0, Column 2
Fair
Row 0, Column 3
Poor
Row 0, Column 4
Not Applicable
Row 0, Column 5
Excellent
Row 1, Column 0
Very Good
Row 1, Column 1
Good
Row 1, Column 2
Fair
Row 1, Column 3
Poor
Row 1, Column 4
Not Applicable
Row 1, Column 5
Excellent
Row 2, Column 0
Very Good
Row 2, Column 1
Good
Row 2, Column 2
Fair
Row 2, Column 3
Poor
Row 2, Column 4
Not Applicable
Row 2, Column 5
Excellent
Row 3, Column 0
Very Good
Row 3, Column 1
Good
Row 3, Column 2
Fair
Row 3, Column 3
Poor
Row 3, Column 4
Not Applicable
Row 3, Column 5
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4
Please rate the following: Medications/Supplies
Excellent
Very Good
Good
Fair
Poor
Not Applicable
Time it takes orders to arrive
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Condition in which my orders arrive
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Effectiveness of health information materials
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Staff's knowledge about medications
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Row 3, Column 5
Appropriateness of supplies
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Row 4, Column 5
Time it takes orders to arrive
Condition in which my orders arrive
Effectiveness of health information materials
Staff's knowledge about medications
Appropriateness of supplies
Excellent
Row 0, Column 0
Very Good
Row 0, Column 1
Good
Row 0, Column 2
Fair
Row 0, Column 3
Poor
Row 0, Column 4
Not Applicable
Row 0, Column 5
Excellent
Row 1, Column 0
Very Good
Row 1, Column 1
Good
Row 1, Column 2
Fair
Row 1, Column 3
Poor
Row 1, Column 4
Not Applicable
Row 1, Column 5
Excellent
Row 2, Column 0
Very Good
Row 2, Column 1
Good
Row 2, Column 2
Fair
Row 2, Column 3
Poor
Row 2, Column 4
Not Applicable
Row 2, Column 5
Excellent
Row 3, Column 0
Very Good
Row 3, Column 1
Good
Row 3, Column 2
Fair
Row 3, Column 3
Poor
Row 3, Column 4
Not Applicable
Row 3, Column 5
Excellent
Row 4, Column 0
Very Good
Row 4, Column 1
Good
Row 4, Column 2
Fair
Row 4, Column 3
Poor
Row 4, Column 4
Not Applicable
Row 4, Column 5
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5
Please rate the following:Overall Cascade service
Excellent
Very Good
Good
Fair
Poor
Not Applicable
Service Quality
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Service Quality
Excellent
Row 0, Column 0
Very Good
Row 0, Column 1
Good
Row 0, Column 2
Fair
Row 0, Column 3
Poor
Row 0, Column 4
Not Applicable
Row 0, Column 5
6
Please answer the following questions for our information: What else can Cascade do to better serve your needs?
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7
Any additional comments or suggestions
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