Oregon Reproductive Medicine Patient Satisfaction Survey

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1. My experience making my first call to ORM and making my appointment was:

My experience making my first call to ORM and making my appointment was:   Excellent Good Average Below Average

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2. My first impression of ORM when I arrived was:

My first impression of ORM when I arrived was:   Excellent Good Average Below Average

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3. My experience with the reception staff at ORM was:

My experience with the reception staff at ORM was:   Excellent Good Average Below Average

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4. My experience with the clinical staff (nurses, coordinators, medical assistants, phlebotomists,etc.) at ORM was:

My experience with the clinical staff (nurses, coordinators, medical assistants, phlebotomists,etc.) at ORM was:   Excellent Good Average Below Average

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5. My experience with my ORM physician during my consultation, testing, treatment and follow up was:

My experience with my ORM physician during my consultation, testing, treatment and follow up was:   Excellent Good Average Below Average

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6. My experience with the laboratory staff (Andrology/Embryology) was:

My experience with the laboratory staff (Andrology/Embryology) was:   Excellent Good Average Below Average

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7. My experience with the billing office and financial counselor at ORM was:

My experience with the billing office and financial counselor at ORM was:   Excellent Good Average Below Average

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8. Did you have adequate face to face and phone time with ORM's nursing staff?

Did you have adequate face to face and phone time with ORM's nursing staff?   Yes No

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9. Over all, my needs were met while I was a patient at ORM.

Over all, my needs were met while I was a patient at ORM.   Yes No

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10. I would recommend ORM to my friends and/or family.

I would recommend ORM to my friends and/or family.   Yes No

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