Utah Telehealth Network
585 Komas Dr.
Suite 204
SLC, UT 84108
phone: 801-585-2426
fax: 801-585-2527

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Survey Forms

We are committed to providing excellent service through Telehealth. Your comments are very important to us and will assist us in improving future Telehealth sessions. Please take a few moments to select the form that most appropriately describes your video experience. Please fill it out and either give it to your Facility Coordinator or fax it to 801-585-1875.

Education Satisfaction Survey:
Complete this form if you have participated in an educational event.

Meeting Satisfaction Survey
Complete this form if you have participated as an audience member.

Patient Satisfaction Survey
Complete this form if you have been seen by a provider.

Consultant Satisfaction Survey
Complete this form if you have provided clinical services.

Speaker Satisfaction Survey
Complete this form if you have presented to an audience.


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