Client Survey Client Services Quarterly Survey Survey Date “2023” NEW DAY HOME CARE QUARTER SURVEY First Qtr.Second Qtr.Third Qtr.Fourth Qtr. Client Name Client Name First First Last Last Caregiver Name/s Caregiver Name/s First First Last Last Survey Taken By Survey Taken By First First Last Last CLIENT FEEDBACK Do you feel comfortable with your NDHC caregiver? YES NO AT TIMES Is caregiver personable and communicate with you daily? YES NO AT TIMES Are all services usually completed by the end of shift? YES NO AT TIMES Is caregiver distracted by phone calls & text messages? YES NO AT TIMES Does caregiver follow instructions on daily assigned task? YES NO AT TIMES Does your caregiver usually arrived on time & work the full shift? YES NO AT TIMES Are assigned duties completed by staff to your satisfaction? YES NO AT TIMES Do you receive monthly visits or bi-weekly calls by NDHC case manager? YES NO AT TIMES Are you satisfied with the customer service you received when you call New Day Home Care business office? YES NO AT TIMES Does your caregiver work with you to achieve the goals set forth in your care plan? YES NO AT TIMES How would you rate the services you received from New Day Home Care over this past 3 months? GOOD “Services provided met my expectations most of the times” NOT GOOD “Services needs improvement in some areas. (communication & services) GREAT “Services provided meet my expectations all the times. Caregiver is dedicated to my care. Office staff is polite & helpful, provides good customer service & resolution when there is an issue. Do you have any other concerns you want NDHC management to know about? YES NO What would you suggest we change or do differently to make your services more satisfying for you? NDHC SURVEY NOTES: Please add below any information consumer offered or what you observed during the survey.. If you are human, leave this field blank. Submit Δ{{#message}}{{{message}}}{{/message}}{{^message}}Your submission failed. The server responded with {{status_text}} (code {{status_code}}). Please contact the developer of this form processor to improve this message. Learn More{{/message}}{{#message}}{{{message}}}{{/message}}{{^message}}It appears your submission was successful. Even though the server responded OK, it is possible the submission was not processed. Please contact the developer of this form processor to improve this message. Learn More{{/message}}Submitting…
