Customer Satisfaction Survey Thank you for taking the time to complete our short survey, your feedback is important to us. Question Title * 1. Which of the following words and phrases would you use to describe our services? Select all that apply. Reliable High quality Helpful Expert Easy to use Flexible Responsive Good value Unreliable Inflexible Unresponsive Ineffective Poor quality Poor value OK Question Title * 2. How well do our services meet your needs? Extremely well Very well Somewhat well Not so well Not at all well OK Question Title * 3. How would you rate the quality of our services? Very high quality High quality Neither high nor low quality Low quality Very low quality OK Question Title * 4. How would you rate the value for money of our services? Excellent Above average Average Below average Poor OK Question Title * 5. How responsive are we? Extremely responsive Very responsive Somewhat responsive Not so responsive Not at all responsive OK Question Title * 6. How likely are you to continue using Gipping OH as your Occupational Health service provider? Extremely likely Very likely Somewhat likely Not so likely Not at all likely OK Question Title * 7. Overall, how satisfied or dissatisfied are you with us? Very satisfied Somewhat satisfied Neither satisfied nor dissatisfied Somewhat dissatisfied Very dissatisfied OK Question Title * 8. How likely is it that you would recommend Gipping OH? NOT AT ALL LIKELY 1 2 3 4 5 6 7 8 9 EXTREMELY LIKELY 10 NOT AT ALL LIKELY 1 2 3 4 5 6 7 8 9 EXTREMELY LIKELY 10 OK Question Title * 9. Do you have any other comments, questions, or concerns? OK Question Title * 10. Which Occupational Health Services might be of interest over the next 12 months? (Tick all that apply New Employee Screening Health Surveillance Programme Hearing Tests Hand Arm Vibration Assessments Lung Function Tests Safety Critical Assessments Management Referrals Drug & Alcohol Testing Face Fit Testing Occupational Vaccinations e.g. Hep A, Hep B & Flu Blood Screening (in relation to Occupational Vaccinations) Biological Monitoring (in relation to specific hazards e.g. Isocyanates) DSE Assessments Employee Assistance Programme Physiotherapy Services Functional Assessments Talking Therapy Services (To support Mental Health) Health & Wellbeing Promotion Mental Health First Aid Training Mental Health Awareness Training First Aid Training Health Questionnaires Health Needs Analysis Other (please specify) OK Question Title * 11. Your company name OK Question Title * 12. Your name OK Question Title * 13. Your job role OK DONE
