Service Recovery | BVRMC Intranet

Service Recovery (H.E.A.T.) Form

H- hear; E-empathize (put yourself in customer’s shoes); A-apologize (blameless); T- take action (what can I do to fix this right now?)

"*" indicates required fields

Date of Event*

Tool Box # / Location

Customer Name

First Last

Patient Phone #

Description of Event

Delay

Equipment Failure

Miscommunication

Patient Assistance/Comfort

Scheduling Issues

Procedure Problem(s)

Other (please write in comments)

Comments / Describe the situation so future improvements can be made.

# Cab Tickets (1 way trip per cab ticket) given

$5 – BVRMC Certificates (use Bistro / Cafe Latte) given

$1 – BVRMC Certificates (use in Bistro / Cafe Latte) given

# Movie Tickets given

# – $5 WalMart (gas) cards given

# Pizza Certificates given

Service Recovery needed other than a Heat Box item?

Employee ID

Department Manager