UHS Patient Satisfaction Survey

1.

 
You were recently seen for an appointment at University Health Services. We value you as a patient and want to know if our services met your needs. As part of this effort, we would be grateful if you would take a few moments and complete this brief survey about your most recent visit. Your responses are completely confidential. The results of these questionnaires are used to evaluate and improve University Health Services. Thank you for your attention and time.

Please note: Survey responses are reviewed on a monthly basis. If you have an emergency or an issue that requires immediate attention, please call the Lindner Center clinic front desk at 556-2564 or in a true emergency, call 911.
1. Is University Health Services your usual source of care and/or primary care provider?
2. For which clinic are you providing feedback today?
3. What was the date of the visit you are providing feedback about today?
MM DD YYYY
Visit Date
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4. Did you have a pre-scheduled appointment for this visit or did you walk in?
5. Rate your satisfaction with the following related to your most recent visit.
IF ANY QUESTION DOES NOT APPLY TO YOUR MOST RECENT VISIT, YOU MAY SKIP THE QUESTION WITHOUT SELECTING A RATING.
0 - Not Satisfied123456 - Very Satisfied
Ease of scheduling an appointment that meets your needs
Amount of time needed in the health service to complete your appointment
Efficiency of the check-in and check-out process
Friendliness, courtesy, and helpfulness of the registration staff
Friendliness, courtesy and helpfulness of the non-provider medical staff (nurses, laboratory technician, medical assistant, etc.)
That the provider listened carefully to your concerns
Amount of time spent with the provider
Quality of the explanations and advice you were given for your condition and the recommended treatment
How well your pain was addressed (if applicable)
Explanations given about payment and billing issues
Your confidentiality and privacy were carefully protected
Cleanliness and general appearance of the health center
Your overall satisfaction with your visit
How likely are you to recommend the health service to another student?
6. Was your visit for mental health services (counseling)?
7. What is your program of study?
8. Are you a veteran or active serviceperson?
9. If any of our staff members were especially helpful during your visit, please let us know so we may acknowledge them. If any of our staff members did not meet your expectations, please let us know that as well.
10. Please include any additional comments about your visit to the health service you would like us to know.
11. Would you like a health service staff member to contact you about your visit? If so, please include your name, a telephone number and/or e-mail address. NOTE: All issues will be addressed in a confidential manner.
Thank you for your time and attention. Please note: Survey responses are reviewed on a monthly basis. If you have an emergency or an issue that requires immediate attention, please call the Lindner Center clinic front desk at 556-2564 or in a true emergency, call 911.
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