Visiting Specialist Patient Satisfaction Survey
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TMC Visiting Specialist Patient Satisfaction Survey

Your feedback is critically important for us to better understand the quality of care and compassion of our Visiting Specialist staff at the Telluride Medical Center. As always if you would like to discuss a matter outside of your below responses, I invite your call to my direct line - 970.728.9782

Thank you,
Gordon Reichard, Executive Director
Telluride Medical Center

1. My visit to TMC was for an:

My visit to TMC was for an: 1. Dr. Vineet Singh - Orthopaedic Consultation

2. Dr. Kelly Bynum - Orthopaedic Consultation

3. Dr. Gloria Biem - Orthopaedic Consultation

4. Dr. Rhett Griggs - Orthopaedic Consultation

5. Dr. Andrew Dahl - Ophthalmology Consultation

6. Mid-wife visit

7. Dr. Craig Peterson - Urology Consultation

8. Dr. William Karls - Mental Health Consultation

9. An Ultrasound

10. A CT Scan or X-ray

11. An Exercise Stress Test

Specify Specialist Name

2. Do you find this service to be a value to you?

Do you find this service to be a value to you? Yes

Other (please specify)

3. Do you find this service to be a convenience to you?

Do you find this service to be a convenience to you? Yes

Other (please specify)

4. Please rate your overall experience:

	Poor	Fair	OK	Good	Great
How do you rate your overall visit experience?	*Please rate your overall experience: How do you rate your overall visit experience? Poor	How do you rate your overall visit experience? Fair	How do you rate your overall visit experience? OK	How do you rate your overall visit experience? Good	How do you rate your overall visit experience? Great

Why was your experience NOT great?

5. What other feedback can you give us to help provide you with the care and service you desire?

What other feedback can you give us to help provide you with the care and service you desire?

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