Home Collection Feedback Form. Name * Phone * Email * A. Promptness and courteous behavior of the phlebotomist * Excellent Good Average Below Average Unacceptable B. Please rate your experience with the waiting time. Time given for sample collection * Excellent Good Average Below Average Unacceptable C. Cleanliness / Grooming of the phlebotomist * Excellent Good Average Below Average Unacceptable D. Experience during sample collection by phlebotomist. * Excellent Good Average Below Average Unacceptable D. Experience during sample collection by phlebotomist. * Excellent Good Average Below Average Unacceptable Additional Comments/ Suggestions: * If you are human, leave this field blank. Submit