Customer Satisfaction Survey

Comfort Keepers' goal is to meet and exceed your service needs. Please choose one response to each of the questions below, then sign and submit. Your feedback is important to us!

10 of 10 answered77%

1.Comfort Keepers Staff are knowledgeable

AgreeMostly AgreeSomewhat DisagreeDisagree

2.Comfort Keepers is responsive to my questions

AgreeMostly AgreeSomewhat DisagreeDisagree

3.My invoices are accurate

AgreeMostly AgreeSomewhat DisagreeDisagree

4.My Caregiver is knowledgeable about the services I receive

AgreeMostly AgreeSomewhat DisagreeDisagree

5.My Caregiver is reliable

AgreeMostly AgreeSomewhat DisagreeDisagree

6.I am notified in a timely manner of changes in Caregivers

AgreeMostly AgreeSomewhat DisagreeDisagree

7.I am satisfied with services provided per my plan of care

AgreeMostly AgreeSomewhat DisagreeDisagree

8.I would recommend Comfort Keepers to others

AgreeMostly AgreeSomewhat DisagreeDisagree

9.Comfort Keepers provides uplifting care that helps me live life the best I can

AgreeMostly AgreeSomewhat DisagreeDisagree

10.I want to speak with management — please call me

Yes, call meNo, not at this time

Customer / Customer representative declined to participate in the Customer Satisfaction Survey.

Acknowledgement

Customer first name *

Customer last name *

Phone number (optional)

Primary Email to receive copy (optional)

Additional CC email (optional)

Relationship to customer * (choose one)

Self — I am the customerFamily MemberCustomer Friend / RepresentativeComfort Keepers Caregiver

Signature (type full name) *

Enter your signature *

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Date: June 9, 2026(auto-stamped — cannot be changed)

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