J & B Client & Family Satisfaction Survey
Share your feedback about your care experience—about 2 minutes. Please avoid medical or health details; call 508-927-1040 for care needs.
Your name
First Name
Last Name
Are you the client or a family member?
*
Client
Family member
Other
Your caregiver's first name
Overall satisfaction
*
1
2
3
4
5
Caregiver arrives on time
*
1
2
3
4
5
Caregiver is kind and respectful
*
1
2
3
4
5
Tasks are done the way I like
*
1
2
3
4
5
The office is easy to reach and responsive
*
1
2
3
4
5
Scheduling changes are handled well
*
1
2
3
4
5
I feel comfortable with my caregiver in my home
*
1
2
3
4
5
Language needs are met
*
1
2
3
4
5
N/A
How likely are you to recommend J&B to a friend or family member?
*
Not at all likely
0
1
2
3
4
5
6
7
8
9
Extremely likely
10
0 is Not at all likely, 10 is Extremely likely
What do you like most about your care?
What could we do better?
May we share your comments (first name and town only) on our website?
*
Yes
No
Would you like a call from Jerry?
*
Yes
No
Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Send
Should be Empty: