Client Satisfaction Form
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Overall, how would you rate your experience working with Diamond Chick Consulting?
1
2
3
4
5
1-Bad 5-Amazing!
How clear did you feel the information was during the plan review process?
Very clear
Mostly clear
Somewhat clear
Not very clear
Did you feel supported throughout Open Enrollment?
Yes — completely
Mostly
Somewhat
No
What part of the process felt most helpful?(Check all that apply)
Initial consultation
Plan comparisons
Explaining costs & coverage
Help with the application/registration
Follow-up communication
Other (please share)
What part of the process felt confusing, stressful, or could have been better?
How was your experience registering/enrolling with your insurance plan?
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Did you feel prepared going into the enrollment or registration step?
Yes, completely
Mostly
Somewhat
No
Was there anything you wish you had known before Open Enrollment started?
How likely are you to recommend Diamond Chick Consulting to a friend, family member, or coworker?
Not Likely
1
2
3
4
5
6
7
8
9
Highly Likely
10
1 is Not Likely , 10 is Highly Likely
If you were explaining Diamond Chick Consulting to someone else, what would you say?
May I share part of your feedback as a testimonial?
Yes
Yes, but anonymously
No
Anything else you’d like me to know?
Thank You For Trusting Diamond Chick Consulting!
Submit
Should be Empty: