Ombudsman Satisfaction Survey

Are You

If you chose other, please specify

How did you initially have contact with the Ombudsman?

If you chose other, please specify

Did the Ombudsman understand your concerns?

Yes

No

Once you shared your concerns, did the Ombudsman act promptly to help you?

Yes

No

Did the Ombudsman maintain contact with you during the investigation?

Yes

No

Did the Ombudsman help resolve your concern to your satisfaction?

Yes

No

Was the Ombudsman courteous and respectful?

Yes

No

Would you contact the Ombudsman if you needed further assistance?

Yes

No

In what county is the long-term care facility?

What suggestions do you have about how we can improve our services?

Any other comments?

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