Applicant survey

Name

Insurance Company

Hidden

Ticket Number

Hidden

Order Number

1. Overall, how satisfied or dissatisfied are you with ExamOne?*

Very satisfied
Somewhat satisfied
Neither satisfied nor dissatisfied
Somewhat dissatisfied
Very dissatisfied

EXAM LOCATION

2. Where was your exam completed?*

At an ExamOne/Quest Diagnostics exam center
At my home
At my workplace

3. Why did you choose to have your exam completed at that location?*

I felt most comfortable at that location
That location was the most convenient place for me
That location offered the best appointment time for me
That was the only option offered to me

SCHEDULING

4. To what extent do you agree with the following statement: The company made it easy for me to schedule my appointment at a time that was convenient for me:*

5. Did we explain the process prior to your exam?*

Yes
No

EXAMINER PERFORMANCE

6. Was the examiner or appointment on time?*

Yes
No

7. Was the examiner courteous and professional?*

Yes
No

8. Did the examiner weigh and measure you?*

Yes
No
N/A- No physical measurements were ordered

LABORATORY RESULTS (Only complete this section if you received your lab results)

9. How satisfied are you with the instructions provided on how to access your lab results?

Very satisfied
Somewhat satisfied
Neither satisfied nor dissatisfied
Somewhat dissatisfied
Very dissatisfied

10. How satisfied are you with how your lab results were displayed?

Very satisfied
Somewhat satisfied
Neither satisfied nor dissatisfied
Somewhat dissatisfied
Very dissatisfied

11. How likely are you to recommend this presentation of laboratory results to a family member or friend?

Please share any additional comments about your experience here

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