Patient Survey
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1. Default Section

 

1. Billing Information for Your Colonoscopy

 Strongly AgreeAgreeDisagreeN/A
1. This brochure was easy to read and understand.
2. The material was presented in an organized manner.
3. You knew who to call with billing questions.
4. You understood the cancellation policy.
5. All of your billing questions were answered.

2. Frequently Asked questions About Your Colonoscopy

 Strongly AgreeAgreeDisagreeN/A
1. The FAQ section contained information that was important to you.
2. You understood why you needed someone to drive you home.
3. The FAQ section addressed and answered all the questions you had after reviewing the instructions.

3. Regarding Medications

 Strongly AgreeAgreeDisagreeN/A
1. You didn't have any questions after reading the Regarding Medication section.
2. You didn't need to call your primary care physician or the gastroenterologist to clarify your medication schedule prior to the procedure.
3. You didn't have concerns about any of your medications? If you did, please explain below.
4. You understood when to take or stop your medications.
5. You understood what instructions to use if you had an EGD and a Colonoscopy scheduled for the same day.
6. It was clear why you needed an office appointment prior to the procedure.

4. Colonoscopy Reminder

 Strongly AgreeAgreeDisagreeN/A
1. You understood “Arrival Time” versus your scheduled “Procedure Time”.
2. The time from your scheduled arrival to your procedure was adequate.
3. Your cleansing preparation experience was better than what you expected.
4. Your procedure experience was better than what you expected.
5. Over all, you were satisfied your experience at our center?

5. 5 Day Checklist

 Strongly AgreeAgreeDisagreeN/A
1. This brochure was easy to read and understand.
2. You didn't find any specific section to be confusing or unclear. If so, which?
3. You brought your signed checklist to the appointment.
4. You found the Helpful Hints useful.
5. You found checking off the glasses of solution helpful when doing the prep.
6. You understood what to do if your stool was NOT clear after completing the prep.
7. You understood the diet restrictions.
8. Overall, you thought the Checklist made the preparation for your procedure easier.
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