GMC Patient Satisfaction Survey 2017

Goshen Medical Center - Patient Satisfaction Survey

Please answer all questions based on most recent visit or most recent call to Goshen.

Question Title

* 1. Which Goshen Medical Site/Location did you visit or call?
Click on the box below to choose a site.

Question Title

* 2. When you contacted Goshen, Were you able to get an appointment as needed?

Yes

N/A

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* 3. If you called Goshen with a question, what was the response time back to you with an answer?

Same day

Next day

2 days or more

N/A

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* 4. Did you see a Goshen Medical Provider within 15 minutes, after completing check-in at the front desk?

Yes

N/A

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* 5. If you experienced any delays or changes affecting your wait time; did Goshen staff keep you informed?

Yes

N/A

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* 6. Were Goshen staff; courteous, professional, and helpful to you?

	Yes	No	N/A
Receptionists and clerks	Receptionists and clerks Yes	Receptionists and clerks No	Receptionists and clerks N/A
Nurses and clinical staff	Nurses and clinical staff Yes	Nurses and clinical staff No	Nurses and clinical staff N/A
Medical Providers- Doctor, Dentist, Physician Assistant, Family Nurse Practitioner	Medical Providers- Doctor, Dentist, Physician Assistant, Family Nurse Practitioner Yes	Medical Providers- Doctor, Dentist, Physician Assistant, Family Nurse Practitioner No	Medical Providers- Doctor, Dentist, Physician Assistant, Family Nurse Practitioner N/A

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* 7. Did the Goshen Provider (Doctor, NP, PA, Dentist, Hygienist)

	Yes	No	N/A
Listen carefully to your concerns	Listen carefully to your concerns Yes	Listen carefully to your concerns No	Listen carefully to your concerns N/A
Provide you with information about care	Provide you with information about care Yes	Provide you with information about care No	Provide you with information about care N/A
Answer any questions	Answer any questions Yes	Answer any questions No	Answer any questions N/A

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* 8. Would you recommend our practice to a family member or friend?

Yes

N/A

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* 9. Any additional comments that would help us improve?

My comment or suggestion

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* 10. Do you want a call regarding this survey?

Yes

If yes, please enter the following contact information: Name, phone number, and best time to call.

Question Title

* 1. Which Goshen Medical Site/Location did you visit or call?Click on the box below to choose a site.

Question Title

* 2. When you contacted Goshen, Were you able to get an appointment as needed?

Question Title

* 3. If you called Goshen with a question, what was the response time back to you with an answer?

Question Title

* 4. Did you see a Goshen Medical Provider within 15 minutes, after completing check-in at the front desk?

Question Title

* 5. If you experienced any delays or changes affecting your wait time; did Goshen staff keep you informed?

Question Title

* 6. Were Goshen staff; courteous, professional, and helpful to you?

Question Title

* 7. Did the Goshen Provider (Doctor, NP, PA, Dentist, Hygienist)

Question Title

* 8. Would you recommend our practice to a family member or friend?

Question Title

* 9. Any additional comments that would help us improve?

Question Title

* 10. Do you want a call regarding this survey?

* 1. Which Goshen Medical Site/Location did you visit or call?
Click on the box below to choose a site.