EMPLOYEE QUALITY IMPROVEMENT SURVEY
EMPLOYEE QUALITY IMPROVEMENT SURVEY
ABX Air, Inc. QHP
Dear Employee:
We value your opinion on the quality of service provided to you by the ABX AIR Inc. QHP. We are committed to providing quality services in a timely matter. In order to help us improve our services, please take a few moments to complete the following questions and return via comat.
RATING SCALE
STRONGLY NO STRONGLY
AGREE AGREE OPINION DISAGREE DISAGREE
1. I was contacted in a timely manner 1 2 3 4 5
by ____________________.
2. I am satisfied with the medical 1 2 3 4 5
treatment obtained.
3. My WC Coordinator was helpful 1 2 3 4 5
in addressing my needs/concerns.
4. I was satisfied with my doctor. 1 2 3 4 5
Additional Comments:
Please Sign:_______________________________________________ ______________________
(Employee's Name ) ( Date )
Address :_______________________________________________ ______________________
( Phone # )
Department:_______________________________________________ ______________________
( Date of Injury )
Again, thank-you for completing this questionnaire, your comments are important!
***Please fold/staple and return via comat to 2061-0***
**OR MAIL TO:
ABX Air, Inc. Qualified Health Plan
145 Hunter Drive
Wilmington, OH 45177
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