Please enable JavaScript in your browser to complete this form.How helpful was the Receptionist? *12345On a scale from 1 to 5, 1 being poor and 5 being excellent, how would you rate the following:How courteous was the Receptionist? *12345On a scale from 1 to 5, 1 being poor and 5 being excellent, how would you rate the following:How satisfied are you with the timeliness of our agency? *12345On a scale from 1 to 5, 1 being poor and 5 being excellent, how would you rate the following:How courteous was the Records Technician? *12345On a scale from 1 to 5, 1 being poor and 5 being excellent, how would you rate the following:Were your needs met? *YesNoIf your needs were not met, were you directed to where you could obtain the information you were seeking?YesNoComments or suggestions that might help us do a better job:NameSubmit
