Client / Customer Aftercare Survey
This survey is private and confidential.
Name
*
First Name
Last Name
Company Name
If Applicable
Email
*
example@example.com
Phone Number
-
Area Code
Phone Number
Client Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Requirement
-
Month
-
Day
Year
Date
I booked Codeblue for:
*
Event Medical Cover
Ambulance Transport Services
Other
Please can you describe your experience with Codeblue Medical
*
How satisfied are you with the initial contact with Codeblue Medical?
*
Very Dissatisfied
1
2
3
4
Extremely Satisfied
5
1 is Very Dissatisfied, 5 is Extremely Satisfied
How easy was it to make and confirm a booking with Codeblue Medical
*
Very Difficult
1
2
3
4
Extremely Easy
5
1 is Very Difficult, 5 is Extremely Easy
How satisfied are you with the quality of pre-event or pre-transport administration? (Such as Medical Plans, Risk Assessments and so on)
*
Very Dissatisfied
1
2
3
4
Extremely Satisfied
5
1 is Very Dissatisfied, 5 is Extremely Satisfied
How satisfied are you with the Quality of Equipment / Vehicles Provided?
*
Very Dissatisfied
1
2
3
4
Extremely Satisfied
5
1 is Very Dissatisfied, 5 is Extremely Satisfied
How satisfied are with the level, type and presentation of the staffing provided?
*
Very Dissatisfied
1
2
3
4
Extremely Satisfied
5
1 is Very Dissatisfied, 5 is Extremely Satisfied
How well do you feel Codeblue Medical provided their services to you?
*
Below Expectations
1
2
3
4
Exceeded Expectations
5
1 is Below Expectations, 5 is Exceeded Expectations
Overall, how satisfied are you with your overall experience with Codeblue Medical today?
*
Very Dissatisfied
1
2
3
4
Extremely Satisfied
5
1 is Very Dissatisfied, 5 is Extremely Satisfied
How likely are you to recommend our services to other organisations?
*
Very Unlikely
1
2
3
4
Very Likely
5
1 is Very Unlikely, 5 is Very Likely
If you have any further comments to make, please let us know here:
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