Patient Satisfaction Self Assessment

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* 1. Contact Information

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* 2. Our patients can schedule appointments readily and easily.

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* 3. Our office responds to patients' telephonic inquiries in a timely manner.

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* 4. Our office/practice contacts patients to remind them of upcoming appointments or tests.

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* 5. Patients see their provider within fifteen minutes of their scheduled appointment time.

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* 6. Providers in our office ensure that patients fully understand the information they are provided.

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* 7. Our office appropriately provides and receives information pertaining to patients' medical history.

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* 8. Providers in our office treat patients with dignity and respect.

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* 9. Providers in our practice spend sufficient time to adequately understand and address patient concerns.

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* 10. Our practice has in place, adequate protocol to monitor and track patients' test results.

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* 11. When discussing treatment (including medication) options, patients are provided with comprehensive information regarding the risks and benefits of each treatment and are able to make informed decisions.

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* 12. I believe my patients understand the information (how, when, why) they are given regarding their prescriptions.

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* 13. Our providers discuss with patients, their preferences regarding the sharing of protected health information.

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* 14. The front desk staff in our office is knowledgeable, courteous and professional.

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* 15. Providers in our office discuss with patients, the importance of a healthy diet, exercise, prevention and patient specific healthcare goals.

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* 16. Our practice offers patients direction with regard to where to obtain tests and/or treatments that cannot be done in our office.

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* 17. At every visit, a medication reconciliation (including OTC medications/supplements) is completed and documented.

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* 18. Providers in our office inquire as to whether patients have experienced feelings of sadness, emptiness, depression or worry/stress?

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* 19. Please provide any additional information about your practice that you feel is relevant to the development of a patient satisfaction performance improvement plan.

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