Skip to content

2021 Premier Surgical Patient Survey

Dear Patient, Thank you for choosing Premier Surgical. Your feedback is important to us. Please complete this brief survey about your experience. To enter the $100 VISA gift card drawing, please enter your email at the end of the survey. Thank you!
1.Which Premier Surgical provider did you see?(Required.)
2.Which Premier Surgical office did you visit?(Required.)
3.How would you rate the ability to make a timely appointment with your surgeon or provider?
Excellent
Good 
Fair 
Poor
4.How would you rate the amount of time you spent in the office waiting room?

Excellent
Good
Fair
Poor
5.How would you rate the amount of time you spent in the exam room?

Excellent
Good
Fair
Poor
6.How well did your Premier Surgical Physician explain your procedure and answer your questions?
Excellent
Good
Fair
Poor
7.Did you have a surgery or procedure? If No, please skip to Question 10.
8.If you had surgery or a procedure, did you receive educational material about the procedure before your surgery?
9.If you had surgery or a procedure, did you receive Pre-op or Discharge instructions?
10.How would you rate the courtesy and professionalism of the Premier Surgical nursing personnel you encountered?
Excellent
Good
Fair
Poor
11.How would you rate the courtesy and professionalism of the Premier Surgical office staff you encountered?
Excellent
Good
Fair
Poor
12.If you had an Ultrasound exam at a Premier Surgical office (not in a hospital), how do you rate the courtesy and professionalism of the Premier Ultrasound Tech?
Excellent
Good
Fair
Poor
N/A
13.Did you contact the Premier Surgical Billing Office about a billing or insurance issue? If NO, please skip to Question 14.
14.If you DID talk to the Premier Surgical Billing Office, how would you rate the courtesy and professionalism of the Billing staff member?
Excellent
Good
Fair
Poor
15.How would you rate the cleanliness and comfort of the Premier Surgical office you visited?
Excellent
Good
Fair
Poor
16.Overall, how would you rate your experience with the Premier Surgical office you visited?
Excellent
Good
Fair
Poor
17.Would you recommend Premier Surgical to your family or friends?
18.What could we have done better to improve your experience with Premier Surgical?
19.If there was a Premier Surgical physician or staff member who left a positive impression on you, please tell us about it.
20.Please enter your email if you would like to be entered in the drawing for a $100 VISA gift card.
3 / 1
300%