Site Feedback

We value your opinion and take your comments into consideration as we continue to make ongoing improvements to the online version of our Provider Directory. Please complete the following informational fields and take a few minutes to complete the brief survey below.

* indicates required field.

First Name:

 Last Name:

 Middle Initial:
Telephone Number (999-999-9999):

Telephone Extension:
Email Address:

Mailing Address:
Mailing Address Line 2:
City:

 State:

Zip Code:

*Comments:



Your opinion is important to us. Please take a moment to answer the survey questions below.

1. What is your satisfaction level with your experience using the electronic version of our Provider Directory?
Very Satisfied Satisfied Neutral Dissatisfied Very Dissatisfied

2. What is your satisfaction level with the overall presentation of the electronic version of our Provider Directory?
Very Satisfied Satisfied Neutral Dissatisfied Very Dissatisfied

3. How well is the electronic version of our Provider Directory meeting your needs?
Completely Somewhat Not very well Not at all

4. What suggestions do you have to improve the electronic version of our Provider Directory?

5. What specific functions or capabilities would you like to see in the electronic version of our Provider Directory?

  
OPD FBK INP 002 EN 092008


Declaración de Privacidad Internet  |   Términos de Uso
© 2008 Blue Cross and Blue Shield of Florida, Inc.