Feedback Survey Form

Disclaimer: We value your feedback and appreciate your time in providing us with your comments. Your privacy is important to us. The information you submit on this form will not be disclosed or shared with any external organization and will only be used to improve our service to you

Organization Name   : * Employee Number  : * Full Name  : * E-Mail ID  : * Contact No  : * Type  : * -----------------------Select----------------------------------------- Feedback Complaint UHC Service  : * ------------------------------------------Select------------------------------------------ Customer Service(Query Resolution) Nurse Line (Pre-Authorization / Letter of Credit) Health Benefit Co-coordinator (Helpdesk at my office) Claim Processing (Registration / Document Recovery / Payout) Lifekonnect - Health Check ups (Pre-Insurance / Pre-Employment) Account Management Online Enrollment Service (e-Enrol Application Tool) Other Reference  : Claim # /URL # / LOC # / LK Request ID # Suggestion/comments  : * Due to security purpose, following special characters are not allowed . !#$%^&*()+=-[]'/{}|\":<> Only allowed special characters .,? Characters remaining Generic FeedBack. Responsiveness from UHC. * 1  :  Excellent. 2  :  Good. 3  :  Satisfied. 4  :  Average. 5  :  Below average. Quality of Service - Health Check Up, Hospitalisation, Claims etc. * 1  :  Excellent. 2  :  Good. 3  :  Satisfied. 4  :  Average. 5  :  Below average. Access to UHC helpdesk. * 1  :  Excellent. 2  :  Good. 3  :  Satisfied. 4  :  Average. 5  :  Below average. Access to UHC contact persons. * 1  :  Excellent. 2  :  Good. 3  :  Satisfied. 4  :  Average. 5  :  Below average. Overall satisfaction level for UHC Service. * 1  :  Excellent. 2  :  Good. 3  :  Satisfied. 4  :  Average. 5  :  Below average.