NCPS Northcrest Ortho Patient Sat
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1
. How did you hear about our office?
How did you hear about our office?
Friend
Relative
Insurance Directory
Internet
Paper/Billboard
Other (please specify)
2
. Please rate your experience with the front desk:
Never
Sometimes
Usually
Always
Your calls were answered in a courteous and helpful manner.
*
Please rate your experience with the front desk: Your calls were answered in a courteous and helpful manner. Never
Your calls were answered in a courteous and helpful manner. Sometimes
Your calls were answered in a courteous and helpful manner. Usually
Your calls were answered in a courteous and helpful manner. Always
Once your call was answered, your requests were handled professionally.
Once your call was answered, your requests were handled professionally. Never
Once your call was answered, your requests were handled professionally. Sometimes
Once your call was answered, your requests were handled professionally. Usually
Once your call was answered, your requests were handled professionally. Always
The receptionist who greeted you was friendly and helpful.
The receptionist who greeted you was friendly and helpful. Never
The receptionist who greeted you was friendly and helpful. Sometimes
The receptionist who greeted you was friendly and helpful. Usually
The receptionist who greeted you was friendly and helpful. Always
You were kept informed of delays.
You were kept informed of delays. Never
You were kept informed of delays. Sometimes
You were kept informed of delays. Usually
You were kept informed of delays. Always
3
. Please rate your experience with the medical staff:
Never
Sometimes
Usually
Always
The medical assistant that escorted you to the room was courteous and helpful.
*
Please rate your experience with the medical staff: The medical assistant that escorted you to the room was courteous and helpful. Never
The medical assistant that escorted you to the room was courteous and helpful. Sometimes
The medical assistant that escorted you to the room was courteous and helpful. Usually
The medical assistant that escorted you to the room was courteous and helpful. Always
The amount of time you waited in the room was reasonable.
The amount of time you waited in the room was reasonable. Never
The amount of time you waited in the room was reasonable. Sometimes
The amount of time you waited in the room was reasonable. Usually
The amount of time you waited in the room was reasonable. Always
The medical assistants answered your questions and concerns in a clear manner.
The medical assistants answered your questions and concerns in a clear manner. Never
The medical assistants answered your questions and concerns in a clear manner. Sometimes
The medical assistants answered your questions and concerns in a clear manner. Usually
The medical assistants answered your questions and concerns in a clear manner. Always
The medical assistants treated you in a caring and respectful manner.
The medical assistants treated you in a caring and respectful manner. Never
The medical assistants treated you in a caring and respectful manner. Sometimes
The medical assistants treated you in a caring and respectful manner. Usually
The medical assistants treated you in a caring and respectful manner. Always
4
. Please comment on the facility:
Never
Sometimes
Usually
Always
The waiting room was clean and comfortable.
*
Please comment on the facility: The waiting room was clean and comfortable. Never
The waiting room was clean and comfortable. Sometimes
The waiting room was clean and comfortable. Usually
The waiting room was clean and comfortable. Always
The exam room was clean and comfortable.
The exam room was clean and comfortable. Never
The exam room was clean and comfortable. Sometimes
The exam room was clean and comfortable. Usually
The exam room was clean and comfortable. Always
The bathroom was clean.
The bathroom was clean. Never
The bathroom was clean. Sometimes
The bathroom was clean. Usually
The bathroom was clean. Always
The office hours are convenient.
The office hours are convenient. Never
The office hours are convenient. Sometimes
The office hours are convenient. Usually
The office hours are convenient. Always
5
. Please select your provider:
Please select your provider:
Dr. Bill Beauchamp
Dr. Mark Cutright
Dr. George Dahir
Stacy Nadler
6
. Please select your location:
Please select your location:
Springfield
Pleasant View
White House
7
. Please rate your experience with that provider:
Never
Sometimes
Usually
Always
You are satisfied with the quality of care you received.
*
Please rate your experience with that provider: You are satisfied with the quality of care you received. Never
You are satisfied with the quality of care you received. Sometimes
You are satisfied with the quality of care you received. Usually
You are satisfied with the quality of care you received. Always
The provider answered your questions and concerns in a clear manner.
The provider answered your questions and concerns in a clear manner. Never
The provider answered your questions and concerns in a clear manner. Sometimes
The provider answered your questions and concerns in a clear manner. Usually
The provider answered your questions and concerns in a clear manner. Always
The provider saw you close to your appointment time.
The provider saw you close to your appointment time. Never
The provider saw you close to your appointment time. Sometimes
The provider saw you close to your appointment time. Usually
The provider saw you close to your appointment time. Always
The provider spent an appropriate amount of time with you.
The provider spent an appropriate amount of time with you. Never
The provider spent an appropriate amount of time with you. Sometimes
The provider spent an appropriate amount of time with you. Usually
The provider spent an appropriate amount of time with you. Always
The provider treated you in a caring and respectful manner.
The provider treated you in a caring and respectful manner. Never
The provider treated you in a caring and respectful manner. Sometimes
The provider treated you in a caring and respectful manner. Usually
The provider treated you in a caring and respectful manner. Always
8
. Overall are you satisfied with your service and would you recommend NorthCrest Orthopedics?
Overall are you satisfied with your service and would you recommend NorthCrest Orthopedics?
Yes
No
9
. What changes would you like to see us make to improve your experience?
What changes would you like to see us make to improve your experience?
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