Patient Satisfaction Questionnaire

 

In your initial contact by phone, were our receptionists:

	Yes	No
Courteous?	In your initial contact by phone, were our receptionists: Courteous? Yes	Courteous? No
Helpful?	Helpful? Yes	Helpful? No

During your visits to the office, were our receptionists:

	Yes	No
Friendly?	During your visits to the office, were our receptionists: Friendly? Yes	Friendly? No
Responsive?	Responsive? Yes	Responsive? No

Did the waiting time seem reasonable to you?

Did the waiting time seem reasonable to you?   Yes No

Other (please specify)