Center for Polar Medical Operations Physical Qualifications Survey

Center for Polar Medical Operations PO SurWl}Center for Polar Medical Operations PQ Survey

@/20113.'

Center for Polar Medical Operations

Survey

,

* 1. My PQ packet was easy to understand and follow.
Strongly Dis~gree

Agree

Neutral

Disagree

Strongly Agree

Specific compli ments/comments?

J

* 2. My PQ forms, dental films and other data were easy to submit.
Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

,

Specific compliments/concerns?

*3. My interactions with ASC/UTMB staff were helpful and professional.
Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

N/A

Specific compli ments/concerns?

1

*4. My questions (via phone or email) resulted in a response from ASCIUTMB within
3 business days.
True

False

N/A

Specific compliments/concerns?

WNN.sur>eyrnon!ley.com!s.aspx?sm=dE1hOKDjp68mqjDeQGQiuQ_3d_3d

,
1/3

Center for Polar Medical Operations PQ SUN»Center for Polar Medical Operations PQ SUr\~y

5120/13

J

*5. I had an overall positive experience with the PQ process.
Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

Specific compliments/concerns?

J

J
6. What recommendation(s) would you make to improve the PQ process for next year?

7. Would you like ASCIUTMB to contact you for additional feedback? If so, please
provide contact information below.

I

Yes
No
Daytime phone number and email:

J
Done

I
Powered by SurveyMonkey
Check out our sarrple surveys and create your ow n now!

WNN.sur\9jmOllkey.comfs.asplOsm=dE1hOKDjp68mqjDeQGQiuQ_3d_3d

213