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* 1. What is your gender?

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* 2. Status

Please rate your satisfaction with all items relevant for you most recent visit.

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* 3. Scheduling an appointment was easy.

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* 4. The wait time for my appointment was acceptable.

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* 5. The check- in and check out processes were efficient.

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* 6. The registration staff was professional, friendly, courteous and helpful.

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* 7. The nursing/medical assistant staff was professional, friendly, courteous and helpful.

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* 8. I spent an adequate amount of time with my provider.

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* 9. My provider thoroughly explained my condition and recommended treatment in a way I could easily comprehend.

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* 10. My questions regarding charges, insurance and billing were answered adequately.

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* 11. I felt my confidentiality and privacy were carefully protected.

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* 12. The Health CARE Center was clean and comfortable.

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* 13. My overall experience was

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* 14. Would you recommend the Health CARE Center

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* 15. Would you use the Health CARE Center again?

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* 16. Do you have any other comments or suggestions which might help us to improve our service to you? All comments, whether positive or negative, are appreciated.

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* 17. If you would like us to respond to your comments please enter your name or email address:

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