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. 

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

Date / Time
/
/
:

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

* 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

* 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

* 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

* 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

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

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

Thank you for your comments!

T