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How would you rate the following?

Excellent Very Good Good Fair Poor Not Applicable
The process of making a referral to Home Care Service.
The courtesy and helpfulness of the BestCare staff.
The BestCare clinical staffs’ (RN) professionalism and expertise.
The timeliness and quality of written documentation about your patients’ care.
The timeliness, frequency and quality of telephone conversations about your patients’ care.
The ease of contacting BestCare staff after working hours (on call staff).
The feedback received from patients about their infusion experience.

Overall how satisfied are you with BestCare’s performance?

Extremely Satisfied Very Satisfied Satisfied Slightly Satisfied Dissatisfied

Though the surveys are anonymous it would be helpful if we knew a little more about you. Which of the following categories best describes you?

Physician
Hospital Discharge Planner
Case Manager
Payor Representative
Other (Please Specify):

Please share any comments below. We would especially like to know how you think we could improve our care.

If you wish to discuss any aspect of the care provided by the BestCare team, please provide your name and daytime telephone number and a representative will contact you.

Name
Email
Contact Number
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