HMO EVALUATION FORM

HMO SERVICES SATISFACTION SURVEY 2025

HMO EVALUATION | 2025

Section 1: Overall Satisfaction

1. Have you accessed HMO services procured by the Organization in 2025?

Yes

2. How satisfied are you with the services provided by our health management organization (Reliance in 2025)?

Very Satisfied

Satisfied

Neutral

Dissatisfied

Very Dissatisfied

3. How would you rate the overall quality of services provided?

Excellent

Good

Fair

Poor

Section 2: Services and Support

4. How helpful have you found the health services provided by our HMO? (Tick all that apply)

Very Helpful

Somewhat Helpful

Not Very Helpful

Not at All Helpful

5. Which services have you utilized? (Tick all that apply)

Outpatient services

Inpatient services

Pharmacy services

Other (please specify)

Section 3: Communication and Accessibility

6. How would you rate the communication from our health management organization?

Excellent

Good

Fair

Poor

7. How accessible are our health services to you?

Very Accessible

Somewhat Accessible

Not Very Accessible

Not at All Accessible

8. How prompt is Approval Request

Very prompt

Some how prompt

Not prompt

Not prompt at all

Section 4: Suggestions and Feedback

9. What areas do you think need improvement?

10. Are there any additional services you would like to see covered?

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