NMPA Patient Satisfaction Survey
 

1. About the Physician

 
Please answer the following questions related to the physician selected from the list below.

If the physician providing you care is not listed, the physician is not a member of North Mississippi Physicians Association and is not participating in this patient satisfaction survey.

Responses should only be provided for physicians providing care in private clinic settings; not in-patient or out-patient hospital settings.

All submitted information is anonymous.

Thank you for taking time to give us your feedback!

*
1. Please select the physician providing care that you wish to currently rate:

2. On a scale of '1' to '5', where '1' is the worst possible care and '5' is the best possible care, how would you rate this physician?

3. On a scale of '1' to '5', where '1' is the worst possible care and '5' is the best possible care, how would you rate this physician's friendliness and caring attitude?

4. How satisfied were you with the amount of time this physician spent with you?

5. About how many minutes did this physician spend with you during your most recent visit?

6. How satisfied were you with the completeness of your exam or check-up?

7. How well did this physician answer your questions?

8. How well did this physician provide information on how to take care of your illness or health condition?

9. How satisified were you with the extent that this physician included you in the decision about your care and treatment?

10. How satisfied were you with the timeliness of recieving test results?

11. How well does this physician (and/or staff) follow- up on any problems or concerns you have?

12. How do you rate your overall treatment success?

13. Were you able to get all the care for your health problem or illness at this clinic?

14. Were you able to see the health care provider you wanted to see at this clinic?

15. How do you rate the convienience of getting advice or help needed from this physician after office hours?

16. Did this physician seem to know important information about your medical history?

17. Did this physician explain things in a way that was easy to understand?

18. Did this physician listen carefully to you?

19. Did this physician (and/or office staff) provide you with easy to understand information about what to do to take care of your health problem or illness?

20. During your visit, did you talk with this physician about any health problems or illness you were experiencing?

21. Did you and this physician talk about specific things you can do to improve your health?

22. Did this physician talk with you about all of the prescription medicines you are currently taking?

23. Have you made an appointment for follow-up care or any continued medical care with this physician?

24. How long has this physician treated you?

25. Would you recommend this physician to your family and friends?

26. Add any additional comments about this physician here. Please identify any particular good things you noted about the visit. Also, please identify anything about the visit that could have been better.

Powered by SurveyMonkey
Create your own free online survey now!