Group Health Behavioral Health Services Patient Satisfaction Survey Page 3

Additional Comments

(Please use the space below for comments about your Behavioral Health visits.)

THANK YOU!

Please send completed survey back in the pre-paid envelope or send to:

ATTN: Quality of Service

Group Health Cooperative

P.O. Box 34589

Seattle, WA 98124-1589

If you have immediate concerns, please call Group Health Customer Service at 1-888-901-4636.

They can respond to your concern. We cannot respond to your written comments on this survey.

All comments remain anonymous during review.

Do not write below this line.

∗↔ΡεθυεστΙ∆≈∗

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3 of 3

12/2006

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Parent category: Life