* 1. How long did you wait to be seen?

* 2. How friendly was the front office staff?

* 3. How easy is it to schedule urgent appointments with your doctor when you're ill?

* 4. What could we do to improve your ability to schedule or reschedule appointments? Would you be interested in a stand-by appointment where you come into the office to be seen by the first available provider based on an appointment opening created by a no-show? You may need to wait up to two hours to be seen.

* 5. Overall, are you satisfied with your healthcare provider?

* 6. Who provided your healthcare and were you satisfied with the care? Could anything be done to improve how we care for you?

* 7. How likely are you to recommend First Coast Neurosciences to family or friends?

* 8. We value your feedback. Is there anything we can do to improve your healthcare experience?

* 9. Do you use concierge medical services or pay for regular aesthetic services provided by a doctor?

  $35-$50 $51-$100 $101-$150 $150+
Yes, and I spend on average per month [select column]
No [leave column blank]

* 10. Do you have any other comments, questions, or concerns?