Patient Satisfaction Survey

1. Patient Satisfaction Survey

 
Please fill out the following patient satisfaction survey.
1. How did you hear about us?
2. Which physician did you see in the clinic?
3. Ease of getting care:
5 - Excellent4 - Good3 - Average2 - Below Average1 - Not Acceptable
Ability to get in and be seen
Convenience of center's location
Prompt return on calls
4. Waiting:
5 - Excellent4 - Good3 - Average2 - Below Average1 - Not Acceptable
Time in waiting room
Time in exam room
Waiting for tests to be performed
Waiting for test results
5. Physician
5 - Excellent4 - Good3 - Average2 - Below Average1 - Not Acceptable
Listens to you
Explains what you want to know
Gives you good advice and treatment
6. Nurses and Medical Assistants
5 - Excellent4 - Good3 - Average2 - Below Average1 - Not Acceptable
Friendly and helpful to you
Answers your questions
7. All Others
5 - Excellent4 - Good3 - Average2 - Below Average1 - Not Acceptable
Friendly and helpful to you
Answers your questions
8. Facility
5 - Excellent4 - Good3 - Average2 - Below Average1 - Not Acceptable
Neat and clean building
Ease of finding where to go
Comfort and Safety while waiting
9. The likelihood of referring your friends and relatives to us
10. What do you like best about our clinic?
11. What do you like least about our clinic?
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