Downeast Health Services  

Satisfaction Survey
At Downeast Health Services, customer satisfaction is very important. We need to hear from you what we do well and what we need to improve upon. Your confidential comments will be sent directly to Kathie Norwood, Executive Director. Thank you for completing this satisfaction survey.
Your Name (optional)
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Program Providing Service:
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Date of Service:

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Please rate the level of satisfaction with your experience:
Professional/Clinical Staff:
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Your satisfaction level with clinical staff:
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Would you recommend us to a friend?
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Additional Comments:
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Administrative/Office Staff:
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Your satisfaction level with office staff:
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Care or Service:
Your satisfaction level with the care you received:
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Additional Comments:
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Overall Visit:
Your satisfaction level the care you received:
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Additional Comments:
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How long did you have to wait?
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If longer than 45 minutes, how long did you have to wait?
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How did you learn about us?
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Tell us about your visit.
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Are you willing to return for follow up care or access additional services?
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If you would like to be contacted concerning your survey, please complete the following information or you may contact Kathie Norwood, Executive Director at 667-5304 ext 238 or at knorwood@downeasthealth.org.
Other Comments:
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Mailing Address:
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City, State and Zip Code
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Phone Number:
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Email Address
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Please enter text in the box exactly as it appears: Please enter text in the box exactly as it appears:
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Website design project was funded by the Robert N. Haskell and Gladys M. Stetson Fund

of the Maine Community Foundation.

Downeast Health Services has locations in Ellsworth, Calais and Machias
info@downeasthealth.org • (207) 667-5304 • 800-492-5550

This site and all content are the property of Downeast Health Services © 2010