DA Form 3611-r Food Service Division-Patient Satisfaction Survey (LRA)

DA Form 3611-r Food Service Division-Patient Satisfaction Survey (LRA)

What Is DA Form 3611-r?

This is a military form that was released by the U.S. Department of the Army (DA) on June 1, 1970. The form, often mistakenly referred to as the DD Form 3611-r, is a military form used by and within the U.S. Army. As of today, no separate instructions for the form are provided by the DA.

FAQ

Q: What is DA Form 3611-r?
A: DA Form 3611-r is the Food Service Division-Patient Satisfaction Survey form.

Q: What does LRA stand for in the document title?
A: LRA stands for Local Resident Advisor.

Q: Who uses DA Form 3611-r?
A: The Food Service Division uses DA Form 3611-r for patient satisfaction surveys.

Q: What is the purpose of the form?
A: The form is used to gather feedback from patients regarding the food service provided.

Q: Is the form specific to a particular location?
A: No, the form is used in multiple locations.

Q: Who can participate in the survey?
A: Patients who have received food service at the facility being surveyed.

Q: Is the survey anonymous?
A: Yes, the survey is anonymous to encourage honest feedback.

Q: How is the survey administered?
A: The survey can be administered electronically or on paper.

Q: Are the survey results used to make improvements?
A: Yes, the survey results are used to identify areas for improvement in the food service provided.

Q: Are there any instructions provided with the form?
A: Yes, detailed instructions are provided on how to complete the survey.

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Form Details:

  • A 1-page document available for download in PDF;
  • The latest version available from the Army Publishing Directorate;
  • Editable, free, and easy to use;

Download an up-to-date fillable DA Form 3611-r down below in PDF format or browse hundreds of other DA Forms stored in our online database.

Download DA Form 3611-r Food Service Division-Patient Satisfaction Survey (LRA)

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  • DA Form 3611-r Food Service Division-Patient Satisfaction Survey (LRA), Page 1
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