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Donor Survey

We want to know how we are doing. Please take a moment to give us your feedback on your donation experience. 
Your Name
Question 1 2 3 4 5
  1. Courtesy of the Staff 
Poor
Below Average		 Average
Above Average		 Excellent
  1.  Professionalism of Staff 
Poor
Below Average		 Average
Above Average		 Excellent
  1. Competency of Staff
Poor
Below Average		 Average
Above Average		 Excellent
  1. Comfort of surroundings
Poor
Below Average		 Average
Above Average		 Excellent
  1. Comfort of Donation Process 
Poor
Below Average		 Average
Above Average		 Excellent
  1. Availability of appointments
Poor
Below Average		 Average
Above Average		 Excellent
  1. Time you had to wait to donate
 very long long just right    
  1. How likely are you to give blood again
 Not likely Probably Definitely    
The following questions are for our information to help improve our marketing:
How many times do you  donate? 

 First time donor  1-2 times per year  3-6 times per year
more than 6 times per year    I donate but not yearly
What motivates you or what would motivate you to donate routinely?

Where did you make this donation: At a Blood Drive At UTMB Hospital 
Why did you donate?         
N/A
Telephone call
Post Card 
Flyer
Replacement credit for someone I know who received blood
Friends asked

I was called and scheduled an appt

Blood Drive/Promotion
Other: 

Please tell us about any unpleasant experience.  We want to know so that we can improve our service to you.  

                        

If you enjoyed donating, please encourage those you know to donate blood, too.  If you would like a response to your comments, please give us your name and address or email.