Appointment Feedback
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1
. I had an appointment with?
I had an appointment with?
Dr. Dabbous
Dr. Harden
Dr. Honore
Nurse
Sonographer
2
. The primary reason for my appointment?
The primary reason for my appointment?
returning annual
procedure
OB
nurse
follow up
new patient annual
surgery consult
ultrasound
Other (please specify)
3
. The quality of customer service I received at check in with the front office was
The quality of customer service I received at check in with the front office was
superior
very satisfied
about average
somewhat satisfactory
unsatisfactory
poor
Comments
4
. The quality of customer service I received by the medical staff with the back office staff was
The quality of customer service I received by the medical staff with the back office staff was
superior
very satisfied
about average
somewhat satisfied
unsatisfied
poor
Comments
5
. The wait time to see a provider was
The wait time to see a provider was
superior
very satisfied
about average
somewhat satisfactory
unsatisfactory
poor
6
. My medical issue was addressed effectively by my doctor and the SOWC staff and I’m satisfied with the level of care I received was
My medical issue was addressed effectively by my doctor and the SOWC staff and I’m satisfied with the level of care I received was
strongly agree
agree
neutral
disagree
neutral
strongly disagree
Comments
7
. The amount of time spent with the doctor was
The amount of time spent with the doctor was
superior
very satisfied
about average
somewhat satisfactory
unsatisfactory
poor
Comments
8
. The degree at which all questions were answered to patient satisfaction was
The degree at which all questions were answered to patient satisfaction was
superior
very satisfied
about average
somewhat satisfactory
unsatisfactory
poor
Comments
9
. All necessary documentation was provided at the completion of the appointment.
All necessary documentation was provided at the completion of the appointment.
strongly agree
agree
neutral
disagree
neutral
strongly disagree
Comments
10
. The overall quality of care received at appointment?
The overall quality of care received at appointment?
superior
very satisfied
about average
somewhat satisfactory
unsatisfactory
poor
Comments
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