DA Form 3611-R. Food Service Division-Patient Satisfaction Survey (LRA)

Form DA 3611-R is a survey form used by the Food Service Division to gather feedback from patients regarding their satisfaction with the food service provided by a military medical facility. This form helps assess the quality of the food service and identify areas for improvement to ensure patient satisfaction.

The form consists of sections where patients can provide their feedback and ratings on various aspects of the food service, such as the taste, variety, portion size, cleanliness, and overall satisfaction. It may also include open-ended questions or comment sections for patients to provide additional comments or suggestions.

Important fields in this form include the patient's feedback and ratings on different aspects of the food service, as well as any additional comments or suggestions they may have. It is important for patients to provide honest and constructive feedback to help improve the food service quality.

Application Example: Patients receiving care at a military medical facility can be asked to complete this survey form to provide feedback on the food service. The form should be completed based on the patient's experience and perception of the food service quality. This form helps the Food Service Division assess patient satisfaction and make improvements accordingly.

Related Forms: There may not be direct alternatives to Form DA 3611-R, as it specifically addresses patient satisfaction surveys for the food service division. However, other forms related to customer satisfaction surveys or feedback collection may exist, depending on the specific context or purpose.