This evaluation form is intended to assess the quality, efficiency, and professionalism of the medical and technical assistance services provided to your organization. Your feedback is highly appreciated and will help us continuously improve our operations and service standards.
Company Name
Country
Filled by
Position
Availability of assistance team
ExcellentGoodSatisfactoryNeeds Improvement
Promptness in handling requested tasks
Promptness in answering phone calls
Ease of communication with our team
Consistency of follow-up
Responsiveness during emergencies
Efficiency in resolving problems
Clarity of procedures and explanations
Professionalism and courtesy
Overall satisfaction
Comments and recommendations:
Quality of case management
Availability of medical information
Follow-up and information sharing
Timeliness and efficiency of medical transportation and adherence to scheduled times
Overall satisfaction with medical assistance services
Intervention proposal and quality
Promptness of technical assistance
Timeliness and adherence to scheduled times
Effectiveness of resolution
Overall satisfaction with technical assistance services
Explicit billing
Billing timeliness
Compliance with the agreed tariffs
Clarity of cost containment details on the invoice
Respect of confidentiality requirements
Protection of sensitive information
Compliance with privacy procedures
Your assessment of how confidential and sensitive data are handled in the management of your cases:
Communication
yes
Response time
Case management
Medical coordination and follow up
Technical assistance services
Billing and Cost Management
Any additional comments or suggestions regarding our collaboration would be greatly appreciated:
