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Service Coordination Quality Survey

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The following is a survey to help staff at Innovative Health Care  to serve you better.  Your responses and comments to this survey are completely anonymous.  If you are unable to complete this form, please have your care provider complete it with you.  We appreciate you taking the time to complete this survey, and we welcome any comments you would like to share with us in the comments section towards the end of this survey.
1. Overall, I am satisfied with my Service Coordinator. *This question is required.
Very SatisfiedSatisfiedNeutralDissatisfiedVery Dissatisfied
2. My Service Coordinator shows a true interest in me. *This question is required.
Very SatisfiedSatisfiedNeutralDissatisfiedVery Dissatisfied
3. My Service Coordinator demonstrates follow through. *This question is required.
Very SatisfiedSatisfiedNeutralDissatisfiedVery Dissatisfied
4. My Service Coordinator attends appropriate meetings with me as I request. *This question is required.
5. My Service Coordinator reviews my plan with me and my provider on a monthly basis. *This question is required.
6. My TSC responds to me in a timely manner  and I am aware of how to contact IHCC on a 24-hour basis. *This question is required.
7. I have a copy of my Service Coordination Plan. *This question is required.
8. My Service Coordinator helps me receive the assistance I need to be as independent as possible. *This question is required.
Very SatisfiedSatisfiedNeutralDissatisfiedVery Dissatisfied
9. Overall, I am satisfied with all of the services I receive to help me be more independent. *This question is required.
Very SatisfiedSatisfiedNeutralDissatisfiedVery Dissatisfied
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