Consumer Survey

1. What is your relationship to New Horizons Home Care, Inc.?

2. What services do you receive from New Horizons Home Care, Inc.?

3. Overall, how satisfied are you with the services that we provide?

Please tell us why:

4. Rate your level of satisfaction on the following:

Cooperation from Staff

Timeliness of Follow-Up

Organization of Services

Quality of Services Provided

Please list any ways you feel that we can improve our services.

5. Would you recommend our services to others?

Why or Why not?

6. How often do you have contact with New Horizons Home Care, Inc. staff?

7. List other services you would like to see offered that are not currently offered by New Horizons Home Care, Inc.

You may choose to complete this survey anonymously, however, if you would like to include your contact information below, it will assure that we can follow up on any concerns that you might have expressed.

Name:

Phone:

Email:

On behalf of those we serve, we thank you for your input.
This information will be used to improve the way we conduct our business and provide services to others.