Health New England, How Can We Help?

Could you spare two minutes to help us update our records? All you have to do is answer the two simple questions below. This information will help us evaluate doctors' responses when members call after business hours.

We appreciate your help!

To complete the Survey on-line, fill in the information below, then click SUBMIT when finished. Or, if you would prefer, you may print this page and fax the completed questionnaire to 413-233-2751.

Provider after-hours response system must enable members to reach an on-call physician 24 hours a day, seven days a week.

1. How does your office handle this?:

	Answering Service.
	If so, name of service:
	Answering machine provides instructions.
	If so, please provide message text:

	Other, please specify:

2. Once notified of a patient call, on average, how quickly is the call returned?:

15 minutes

30 minutes

60 minutes

Between one and two hours

Other

Practice Name or PCP Name:
Street Address:

City:
State:		Zip:

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