Hours of Operation
Monday-Friday 8:00AM - 7:00PM
Saturday 9:00AM - 3:00PM
Sunday Closed

 

For more information, please contact KCHC Customer Service at 907-481-5000

Patient Satisfaction Survey


 


Patient Name



Date of Visit



In the past 12 months, when you made an appointment for a check-up or for routine care, how often did you get an appointment as soon as you needed it?


Comments:




In the past 12 months, how often did your healthcare provider explain things in a way that was easy to understand?


Comments:




In the past 12 months, when a KCHC healthcare provider ordered a blood test, x-ray or other test for you, how often did someone from KCHC follow up to give you those results.


Comments:




In the past 12 months, did anyone at KCHC ask you if there are things that make it hard for you to take care of your health?


Comments:



Do you/your family qualify for our Sliding Fee Family Discount?



Are there any KCHC staff members that you would like us to honor, recognize or thank on your behalf?



Please rate your check-in experience with our Front Desk Staff:


Comments:



Please rate your experience with the person who assisted your KCHC Provider today:


Comments:



Please rate your experience with your KCHC Physician, Physician Assistant or Nurse Practitioner at this visit.


Comments:




May we contact you regarding any of your answers or comments above?


Phone

Email


Type of Visit?




Moving to Kodiak?


New Patient Registration


  • Registration Packet

  • Release of Health Information


  • Release of Information (ROI) Form


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