Satisfaction Survey

Dear Patient
It is our goal to provide top quality care and service to our patients. Please take a moment to give us your feedback so we can improve our operations. Thank you for taking the time to complete this survey.
Choose Your Physician*

Your Appointment
Please skip any survey items that do not apply to you.
Ease of making your appointment by phone
Excellent Very Good Good Poor Very poor
Appointment available within a reasonable time
Excellent Very Good Good Poor Very poor
Appointment available within a reasonable time
Excellent Very Good Good Poor Very poor
The efficiency of the check-in process
Excellent Very Good Good Poor Very poor
Waiting time in the reception area
Excellent Very Good Good Poor Very poor
Ease of getting a referral when you needed one
Excellent Very Good Good Poor Very poor

Our Staff
Please skip any survey items that do not apply to you.
The courtesy of the person who took your call
Excellent Very Good Good Poor Very poor
The friendliness and courtesy of the receptionist
Excellent Very Good Good Poor Very poor
The caring concern of our nurse/medical assistant
Excellent Very Good Good Poor Very poor
The helpfulness of billing/insurance personnel
Excellent Very Good Good Poor Very poor
The professionalism and courtesy of our lab staff
Excellent Very Good Good Poor Very poor

Our Communication with You
Please skip any survey items that do not apply to you.
Your calls are answered within a reasonable amount of time
Excellent Very Good Good Poor Very poor
Your test results are reported in a reasonable amount of time
Excellent Very Good Good Poor Very poor
Our ability to return your calls in a timely manner
Excellent Very Good Good Poor Very poor

Your Visit with the Provider
Please skip any survey items that do not apply to you.
Willingness to listen carefully to you
Excellent Very Good Good Poor Very poor
Takes time to answer your questions
Excellent Very Good Good Poor Very poor
Amount of time spent with you
Excellent Very Good Good Poor Very poor
The thoroughness of the examination
Excellent Very Good Good Poor Very poor
Caring attitude
Excellent Very Good Good Poor Very poor

Dear Patient