OBJECTIVES: Many factors seem to influence patients’ dissatisfaction with a referral system including; lack of timeliness of information from the referring specialists, inadequate information on referrals notes, lack of clarity of the content in referral notes. Breakdown in communication on the referral process can also lead to poor continuity of care, delayed diagnosis, increased litigation and decreased quality of care. Challenges in meeting patients’ satisfaction with referral systems also include, physician time constraints, lack of clarity about reasons for referrals, patient self-referral limitations imposed by managed care and unclear follow up plans. The objective of this study was to estimate and describe the proportion of patients who were satisfied with the patients referral and counter referral process. METHODS: Quasi -experimental study was carried out in two sub- locations in rural Kenya where one hundred CHWs were trained on community-based-referral and counter-referral model and issued with referral tools. Each was assigned 25 households, instructed to regularly visit them in order to identify sick persons counsel and refer them to link hospitals. One hundred villages comprising 2209 households with a population of 11,000 people were covered where the referral model was implemented. Tally sheets were used to categorize referral recommendations. Satisfaction was defined as reported in survey response as, dissatisfied, neutral and satisfied. RESULTS: On patient satisfaction or dissatisfaction only two hundred and twenty eight respondents answered the questions of whom only 38% (37/117)   reported that they were satisfied with the patient referral and counter referral process while 62% (80/117) were neutral. CONCLUSIONS: Two thirds of the respondents were undecided. They were neither  satisfied nor dissatisfied with the referral process. This is a significant proportion which in the view of the authors, there is need for further investigation to establish factors that are likely to make patients remain neutral .