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Admin and Sales Pre-Program Questionnaire

Administrator and Sales Questionnaire

Name
First Last
Date
MM slash DD slash YYYY
Company Name
When a family is interviewing multiple agencies to provide dementia care, how well do you feel you are positioned to win the business?
- 1 - Not well
- 2 - A little
- 3 - Somewhat
- 4 - Pretty well
- 5 - Extremely well
When a family calls on the phone to learn more about your dementia services, how confident are you that your intake person will be able to secure an appointment?
- 1 - Not confident
- 2 - A little confident
- 3 - Somewhat confident
- 4 - Pretty confident
- 5 - Extremely confident
How would you rate your agency in terms of having a true marketing differentiator compared to your competition?
- 1 - No different
- 2 - A little different
- 3 - Somewhat different
- 4 - Pretty different
- 5 - Extremely different
When you are in a conversation with a potential referral source, how often does dementia care come up?
- 1 - Never
- 2 - A little
- 3 - Somewhat often
- 4 - Pretty often
- 5 - Always
Do you feel that your current referral sources are referring your agency the majority of dementia referrals?
- 1 - Do not capture majority
- 2 - A little
- 3 - Somewhat often
- 4 - Pretty often
- 5 - Capture the majority
Do you feel confident that your caregivers are adequately trained in dementia care?
- 1 - Not confident
- 2 - A little confident
- 3 - Somewhat confident
- 4 - Pretty confident
- 5 - Extremely confident
Who do you feel has the best dementia program in the area and why?
Do you have items for demonstration purposes about your dementia program?
What marketing collateral do you have to give out for dementia?

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