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Green Country Rehabilitation Satisfaction Survey
Thank you so much for utilizing Green Country Rehabilitation for your therapy needs.  We appreciate your business and highly value your opinion.  If you would like to discuss this survey or any other issue further, please feel free to contact us at any time.
Agency Name:
Completed by:
1)Your level of satisfaction with GCR's customer service:
2)Communication between GCR and your HH agency:
3)Promptness in having questions answered, needs met and issues addressed:
4)Friendliness of GCR office staff:
5)GCR online therapy system (e.g. ease of sending referrals, viewing & printing notes):
6)Promptness of referral completion:
7)Content of therapy notes (e.g. vitals, patient level of function, plan of care):
8)Overall satisfaction with Green Country Rehab:
Please list any other additional comments regarding Green Country Rehab:
Thank you for taking the time to complete this survey. We appreciate your feedback!
5 Excellent4 Very Good3 Good2 Fair1 Poor
5 Excellent4 Very Good3 Good2 Fair1 Poor
5 Excellent4 Very Good3 Good2 Fair1 Poor
5 Excellent4 Very Good3 Good2 Fair1 Poor
5 Excellent4 Very Good3 Good2 Fair1 Poor
5 Excellent4 Very Good3 Good2 Fair1 Poor
5 Excellent4 Very Good3 Good2 Fair1 Poor
5 Excellent4 Very Good3 Good2 Fair1 Poor