Registry Survey

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Registry Survey

PLEASE NOTE: this survey is intended to get feedback on how Dependable In Home Care and its office employees are doing; it is NOT a survey for reviewing the caregivers referred by our registry.

These surveys will be reviewed by the Chief Operating Officer. We truly hope we have exceeded your expectations, but if we haven’t, we’d like the opportunity to improve.

(For a downloadable/printable PDF of this survey, click here.)

1. Client's Name (if you'd like to remain anonymous, please just leave this blank):

2. My Referral Specialist is (choose one):

3. My Referral Specialist (check all that apply):

is professionalis courteousis helpfulis passionate about her jobis knowledgeable

is sometimes short or rude (unprofessional)is apathetic (not passionate about her job)does not really listen to my needsdoes not communicate thoroughly or in a timely manneris never the same person, so I don’t know how to answer this!

4. Please list any specific compliments or complaints about your Referral Specialist:

5. Has Dependable lived up to its name and reputation? Why or why not?

Contact Information

SOUTHSHORE

702 N. Carrollton Ave.
New Orleans, LA 70119
Tel: (504) 486-5044
Email: help@dependablecare.net

NORTHSHORE

Tel: (985) 690-6353
Email: help@dependablecare.net

Registry Survey

Contact Information

Dependable In Home Care Location