Customer Satisfaction Survey Form

Beneficiary Satisfaction Survey

Please take a moment to fill out this survey
On which island did you last visit the Medicaid Office?*

SaipanTinianRota
What was the purpose of your visit?*

New or Returning ApplicantRenewal RedeterminationPick-up Medicaid CardAdd/Withdraw a DependentFollow-up on Application
Were you able to complete the purpose of your visit?*

YesNo
Is the current Medicaid walk-in hours convenient for you?*

YesNo
Select all options that would be more convenient for you

Open on Saturdays from 7:30am - 11:30amOpen every Friday from 7:30am - 1:00pmExtending walk-in hours to 3:30pm on Mondays thru Thursdays

How would you rate:*

Please leave a comment to let us know how we can improve our operations to serve you better.
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Beneficiary Satisfaction Survey