Western Infectious Disease Consultants, P.C.

Wheat Ridge Office
3885 Upham St, Suite 200
Wheat Ridge, CO 80033-4800

Broomfield Office
3303 W 144th Ave Suite 103
Broomfield, CO 80023

In an effort to assure quality care in our facility, we would appreciate your completing the following questionnaire. 
What is the date and time of your Procedure/Visit?

Question Title

* 1. What is the date and time of your Procedure/Visit?

Date / Time
Please rate the ease of scheduling the date and time of your appointment.

Question Title

* 2. Please rate the ease of scheduling the date and time of your appointment.

Please rate your satisfaction with the amount of time you waited to be seen after your scheduled appointment time.

Question Title

* 3. Please rate your satisfaction with the amount of time you waited to be seen after your scheduled appointment time.

  Poor Reasonable Excellent N/A
Doctor's Office
Infusion Center
Please rate the ability of the staff to make themselves available to answer your questions and explain procedures.

Question Title

* 4. Please rate the ability of the staff to make themselves available to answer your questions and explain procedures.

  Poor Reasonable Excellent N/A
Doctors
Nurses
Medical Assistants
Receptionists
Billing Department
Please rate the the manner in which your questions, concerns, and problems were addressed by:

Question Title

* 5. Please rate the the manner in which your questions, concerns, and problems were addressed by:

  Poor Reasonable Excellent N/A
Doctors
Nurses
Medical Assistants
Receptionists
Billing Department
Please rate the courtesy of the staff regarding your questions, concerns, and problems.

Question Title

* 6. Please rate the courtesy of the staff regarding your questions, concerns, and problems.

  Poor Reasonable Excellent N/A
Doctors
Nurses
Medical Assistants
Receptionists
Billing Department
Were there any problems you did not anticipate?

Question Title

* 7. Were there any problems you did not anticipate?

How might we improve quality care within our practice?

Question Title

* 8. How might we improve quality care within our practice?

Thank you for your comments!

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