Patient Satisfaction Survey

Oklahoma City Indian Clinic Patient Satisfaction Survey

We would like to know how you feel about the services we provide so we can make sure we are meeting your needs. Your responses are directly responsible for improving these services. All responses will be kept confidential and anonymous. Thank you for your time and input.

1. What is your current age?

What is your current age?

2. Gender

Gender Female

Male

3. Insurance Coverage

Insurance Coverage Private

Medicaid

Medicare

None

4. Ease of getting care

	Great	Good	OK	Fair	Poor
Ability to get in to be seen	*Ease of getting care Ability to get in to be seen Great	Ability to get in to be seen Good	Ability to get in to be seen OK	Ability to get in to be seen Fair	Ability to get in to be seen Poor
Hours Clinic is open	Hours Clinic is open Great	Hours Clinic is open Good	Hours Clinic is open OK	Hours Clinic is open Fair	Hours Clinic is open Poor
Convenience of Clinic's location	Convenience of Clinic's location Great	Convenience of Clinic's location Good	Convenience of Clinic's location OK	Convenience of Clinic's location Fair	Convenience of Clinic's location Poor
Prompt return on calls	Prompt return on calls Great	Prompt return on calls Good	Prompt return on calls OK	Prompt return on calls Fair	Prompt return on calls Poor

Other (please specify)

5. Waiting

	Great	Good	OK	Fair	Poor
Time in waiting area	*Waiting Time in waiting area Great	Time in waiting area Good	Time in waiting area OK	Time in waiting area Fair	Time in waiting area Poor
Time in exam room	Time in exam room Great	Time in exam room Good	Time in exam room OK	Time in exam room Fair	Time in exam room Poor
Waiting for tests to be performed	Waiting for tests to be performed Great	Waiting for tests to be performed Good	Waiting for tests to be performed OK	Waiting for tests to be performed Fair	Waiting for tests to be performed Poor
Waiting for test results	Waiting for test results Great	Waiting for test results Good	Waiting for test results OK	Waiting for test results Fair	Waiting for test results Poor

Other (please specify)

6. Staff

	Great	Good	OK	Fair	Poor
Provider listens to you	*Staff Provider listens to you Great	Provider listens to you Good	Provider listens to you OK	Provider listens to you Fair	Provider listens to you Poor
Provider takes enough time with you	Provider takes enough time with you Great	Provider takes enough time with you Good	Provider takes enough time with you OK	Provider takes enough time with you Fair	Provider takes enough time with you Poor
Provider explains what you want to know	Provider explains what you want to know Great	Provider explains what you want to know Good	Provider explains what you want to know OK	Provider explains what you want to know Fair	Provider explains what you want to know Poor
Provider gives you good advice and treatment	Provider gives you good advice and treatment Great	Provider gives you good advice and treatment Good	Provider gives you good advice and treatment OK	Provider gives you good advice and treatment Fair	Provider gives you good advice and treatment Poor
Nurses are friendly and helpful to you	Nurses are friendly and helpful to you Great	Nurses are friendly and helpful to you Good	Nurses are friendly and helpful to you OK	Nurses are friendly and helpful to you Fair	Nurses are friendly and helpful to you Poor
Nurses answer your questions	Nurses answer your questions Great	Nurses answer your questions Good	Nurses answer your questions OK	Nurses answer your questions Fair	Nurses answer your questions Poor
All other staff are friendly and helpful to you	All other staff are friendly and helpful to you Great	All other staff are friendly and helpful to you Good	All other staff are friendly and helpful to you OK	All other staff are friendly and helpful to you Fair	All other staff are friendly and helpful to you Poor
All other staff answer your questions	All other staff answer your questions Great	All other staff answer your questions Good	All other staff answer your questions OK	All other staff answer your questions Fair	All other staff answer your questions Poor

Other (please specify)

7. Facility

	Great	Good	OK	Fair	Poor
Neat and clean building	*Facility Neat and clean building Great	Neat and clean building Good	Neat and clean building OK	Neat and clean building Fair	Neat and clean building Poor
Ease of finding where to go	Ease of finding where to go Great	Ease of finding where to go Good	Ease of finding where to go OK	Ease of finding where to go Fair	Ease of finding where to go Poor
Comfort and safety while waiting	Comfort and safety while waiting Great	Comfort and safety while waiting Good	Comfort and safety while waiting OK	Comfort and safety while waiting Fair	Comfort and safety while waiting Poor
Privacy	Privacy Great	Privacy Good	Privacy OK	Privacy Fair	Privacy Poor

Other (please specify)

8. Oklahoma City Indian Clinic Wellness Center

	Great	Good	OK	Fair	Poor
Convenience of Wellness Center's location	*Oklahoma City Indian Clinic Wellness Center Convenience of Wellness Center's location Great	Convenience of Wellness Center's location Good	Convenience of Wellness Center's location OK	Convenience of Wellness Center's location Fair	Convenience of Wellness Center's location Poor
Hours Wellness Center is open	Hours Wellness Center is open Great	Hours Wellness Center is open Good	Hours Wellness Center is open OK	Hours Wellness Center is open Fair	Hours Wellness Center is open Poor
Equipment available	Equipment available Great	Equipment available Good	Equipment available OK	Equipment available Fair	Equipment available Poor

Other (please specify)

9. Confidentiality

	Great	Good	OK	Fair	Poor
Keeping my personal information private	*Confidentiality Keeping my personal information private Great	Keeping my personal information private Good	Keeping my personal information private OK	Keeping my personal information private Fair	Keeping my personal information private Poor

Other (please specify)

10. Referral

	Great	Good	OK	Fair	Poor
The likelihood of referring your friends and relatives to us?	*Referral The likelihood of referring your friends and relatives to us? Great	The likelihood of referring your friends and relatives to us? Good	The likelihood of referring your friends and relatives to us? OK	The likelihood of referring your friends and relatives to us? Fair	The likelihood of referring your friends and relatives to us? Poor

Other (please specify)

11. Do you consider the Oklahoma City Indian Clinic your regular source of care?

Do you consider the Oklahoma City Indian Clinic your regular source of care? Yes

Other (please specify)

12. What do you like best about our Clinic?

What do you like best about our Clinic?

13. What do you like least about our Clinic?

What do you like least about our Clinic?

14. Suggestions for improvement?

Suggestions for improvement?

Patient Satisfaction SurveyExit this survey

Oklahoma City Indian Clinic Patient Satisfaction Survey

1. What is your current age?

2. Gender

3. Insurance Coverage

4. Ease of getting care

5. Waiting

6. Staff

7. Facility

8. Oklahoma City Indian Clinic Wellness Center

9. Confidentiality

10. Referral

11. Do you consider the Oklahoma City Indian Clinic your regular source of care?

12. What do you like best about our Clinic?

13. What do you like least about our Clinic?

14. Suggestions for improvement?

Patient Satisfaction Survey
Exit this survey