Bellegrove Ob/Gyn Patient Satisfaction Survey
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1
. How would you rate your overall satisfaction with your visit?
How would you rate your overall satisfaction with your visit?
Poor
Somewhat Poor
Average
Good
Excellent
N/A
Other (please specify)
2
. If this was your first visit, what is the likelihood you would return to this office?
If this was your first visit, what is the likelihood you would return to this office?
yes
no
possibly
N/A
3
. How likely are you to recommend this office to family and friends?
How likely are you to recommend this office to family and friends?
Yes
No
Possibly
4
. How easy was it to schedule a visit with this office?
How easy was it to schedule a visit with this office?
Very unacceptable
Somewhat unacceptable
Acceptable
Very acceptable
N/A
5
. Was the person who answered your call courteous and helpful?
Was the person who answered your call courteous and helpful?
Poor
Somewhat Poor
Average
Good
Excellent
N/A
Other (please specify)
6
. Was the reception staff professional and helpful at your check in?
Was the reception staff professional and helpful at your check in?
Poor
Somewhat Poor
Average
Good
Excellent
N/A
Other (please specify)
7
. The comfort, cleanliness and amenities of the office was;
The comfort, cleanliness and amenities of the office was;
Very unacceptable
Somewhat unacceptable
Acceptable
Very acceptable
N/A
Other (please specify)
8
. Length of time you waited to see the provider was;
Length of time you waited to see the provider was;
Very unacceptable
Somewhat unacceptable
Acceptable
Very acceptable
N/A
Other (please specify)
9
. The professionalism and helpfulness from the nurse or medical assistant was;
The professionalism and helpfulness from the nurse or medical assistant was;
Poor
Somewhat Poor
Average
Good
Excellent
N/A
Other (please specify)
10
. The effectiveness of the nurse or medical assistant was;
The effectiveness of the nurse or medical assistant was;
Poor
Somewhat Poor
Average
Good
Excellent
N/A
11
. Which provider did you see?
Which provider did you see?
Dionne Gallagher, MD
Hal Zimmer, MD
Mitchell Nudelman, MD
Elisabeth Anton, MD
Heather Moore, MD
Keely Brown, MD
Laura Zaccari, PA-C
Jennifer Heuberger, ARNP
Lindsay Hurd, ARNP
12
. Did the provider spend enough time with you during your visit?
Did the provider spend enough time with you during your visit?
Not adequate
Somewhat adequate
Adequate
N/A
Other (please specify)
13
. Explanation of procedures,diagnosis and/or treatment plan was?
Explanation of procedures,diagnosis and/or treatment plan was?
Poor
Somewhat Poor
Average
Good
Excellent
N/A
Other (please specify)
14
. Courtesy of the provider was?
Courtesy of the provider was?
Poor
Somewhat Poor
Average
Good
Excellent
N/A
Other (please specify)
15
. Timeliness of laboratory/ultrasound results were;
Timeliness of laboratory/ultrasound results were;
Poor
Somewhat Poor
Average
Good
Excellent
N/A
Other (please specify)
16
. Ease of retrieving results electronically was;
Ease of retrieving results electronically was;
Poor
Somewhat Poor
Average
Good
Excellent
N/A
Other (please specify)
17
. The mission of Bellegrove Ob/Gyn is to provide excellent healthcare. Please share with us how we can improve our service:
The mission of Bellegrove Ob/Gyn is to provide excellent healthcare. Please share with us how we can improve our service:
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