Patient Satisfaction Survey - Schultz, Titov and Anand

Patient Satisfaction Survey

Welcome to our Patient Satisfaction Survey.

Our goal is to provide quality medical care to our patients. We would like to know how you feel about our medical services operations, physicians and staff members. This survey is completely confidential and anonymous.

Thank you for taking the time to help us meet your needs.

To visit our Patient Portal which is an online communication link between patients and their providers please click the below link:

PrognoCIS Patient Portal

Question Title

* 1. Please identify who is your main Clinician:

Dr. Schultz

Dr. Titov

Dr. Anand

Dr. Fakiri

Wisal Fare, PA

Armida Trezza, CDE

Christina Weahunt, RD, CDE

Comment: (please specify)

Question Title

* 2. Your Appointment

	Excellent	Very Good	Good	Fair	Poor	N/A
Ease of making appointments	Ease of making appointments Excellent	Ease of making appointments Very Good	Ease of making appointments Good	Ease of making appointments Fair	Ease of making appointments Poor	Ease of making appointments N/A
Appointment available within a reasonable amount of time	Appointment available within a reasonable amount of time Excellent	Appointment available within a reasonable amount of time Very Good	Appointment available within a reasonable amount of time Good	Appointment available within a reasonable amount of time Fair	Appointment available within a reasonable amount of time Poor	Appointment available within a reasonable amount of time N/A
The efficiency of the check in process	The efficiency of the check in process Excellent	The efficiency of the check in process Very Good	The efficiency of the check in process Good	The efficiency of the check in process Fair	The efficiency of the check in process Poor	The efficiency of the check in process N/A
Waiting time in the reception area	Waiting time in the reception area Excellent	Waiting time in the reception area Very Good	Waiting time in the reception area Good	Waiting time in the reception area Fair	Waiting time in the reception area Poor	Waiting time in the reception area N/A
Waiting time in the exam room	Waiting time in the exam room Excellent	Waiting time in the exam room Very Good	Waiting time in the exam room Good	Waiting time in the exam room Fair	Waiting time in the exam room Poor	Waiting time in the exam room N/A
Keeping you informed if your appointment time was delayed	Keeping you informed if your appointment time was delayed Excellent	Keeping you informed if your appointment time was delayed Very Good	Keeping you informed if your appointment time was delayed Good	Keeping you informed if your appointment time was delayed Fair	Keeping you informed if your appointment time was delayed Poor	Keeping you informed if your appointment time was delayed N/A
Hours of operation convenient to you	Hours of operation convenient to you Excellent	Hours of operation convenient to you Very Good	Hours of operation convenient to you Good	Hours of operation convenient to you Fair	Hours of operation convenient to you Poor	Hours of operation convenient to you N/A
Overall comfort	Overall comfort Excellent	Overall comfort Very Good	Overall comfort Good	Overall comfort Fair	Overall comfort Poor	Overall comfort N/A

Comment: (please specify)

Question Title

* 3. Our Staff:

	Excellent	Very Good	Good	Fair	Poor	N/A
The courtesy of the person answering the phone	The courtesy of the person answering the phone Excellent	The courtesy of the person answering the phone Very Good	The courtesy of the person answering the phone Good	The courtesy of the person answering the phone Fair	The courtesy of the person answering the phone Poor	The courtesy of the person answering the phone N/A
The friendliness and courtesy of the receptionist	The friendliness and courtesy of the receptionist Excellent	The friendliness and courtesy of the receptionist Very Good	The friendliness and courtesy of the receptionist Good	The friendliness and courtesy of the receptionist Fair	The friendliness and courtesy of the receptionist Poor	The friendliness and courtesy of the receptionist N/A
The caring concern of our Medical Assistants	The caring concern of our Medical Assistants Excellent	The caring concern of our Medical Assistants Very Good	The caring concern of our Medical Assistants Good	The caring concern of our Medical Assistants Fair	The caring concern of our Medical Assistants Poor	The caring concern of our Medical Assistants N/A

Comment: (please specify)

Question Title

* 4. Our Communication With You:

	Excellent	Very Good	Good	Fair	Poor	N/A
Your phone calls answered promptly	Your phone calls answered promptly Excellent	Your phone calls answered promptly Very Good	Your phone calls answered promptly Good	Your phone calls answered promptly Fair	Your phone calls answered promptly Poor	Your phone calls answered promptly N/A
Getting advice or help needed during office hours	Getting advice or help needed during office hours Excellent	Getting advice or help needed during office hours Very Good	Getting advice or help needed during office hours Good	Getting advice or help needed during office hours Fair	Getting advice or help needed during office hours Poor	Getting advice or help needed during office hours N/A
Explanation of recommendations/testing	Explanation of recommendations/testing Excellent	Explanation of recommendations/testing Very Good	Explanation of recommendations/testing Good	Explanation of recommendations/testing Fair	Explanation of recommendations/testing Poor	Explanation of recommendations/testing N/A
Your test results reported in a reasonable amount of time	Your test results reported in a reasonable amount of time Excellent	Your test results reported in a reasonable amount of time Very Good	Your test results reported in a reasonable amount of time Good	Your test results reported in a reasonable amount of time Fair	Your test results reported in a reasonable amount of time Poor	Your test results reported in a reasonable amount of time N/A
Effectiveness of our health information materials	Effectiveness of our health information materials Excellent	Effectiveness of our health information materials Very Good	Effectiveness of our health information materials Good	Effectiveness of our health information materials Fair	Effectiveness of our health information materials Poor	Effectiveness of our health information materials N/A
Our ability to return your calls in a timely manner	Our ability to return your calls in a timely manner Excellent	Our ability to return your calls in a timely manner Very Good	Our ability to return your calls in a timely manner Good	Our ability to return your calls in a timely manner Fair	Our ability to return your calls in a timely manner Poor	Our ability to return your calls in a timely manner N/A
Your ability to contact us after hours	Your ability to contact us after hours Excellent	Your ability to contact us after hours Very Good	Your ability to contact us after hours Good	Your ability to contact us after hours Fair	Your ability to contact us after hours Poor	Your ability to contact us after hours N/A
Your ability to obtain prescription refills by phone	Your ability to obtain prescription refills by phone Excellent	Your ability to obtain prescription refills by phone Very Good	Your ability to obtain prescription refills by phone Good	Your ability to obtain prescription refills by phone Fair	Your ability to obtain prescription refills by phone Poor	Your ability to obtain prescription refills by phone N/A

Comment: (please specify)

Question Title

* 5. Your visit with the Provider:

	Excellent	Very Good	Good	Fair	Poor	N/A
Willingness to listen carefully to you	Willingness to listen carefully to you Excellent	Willingness to listen carefully to you Very Good	Willingness to listen carefully to you Good	Willingness to listen carefully to you Fair	Willingness to listen carefully to you Poor	Willingness to listen carefully to you N/A
Taking time to answer your questions	Taking time to answer your questions Excellent	Taking time to answer your questions Very Good	Taking time to answer your questions Good	Taking time to answer your questions Fair	Taking time to answer your questions Poor	Taking time to answer your questions N/A
Amount of time spent with you	Amount of time spent with you Excellent	Amount of time spent with you Very Good	Amount of time spent with you Good	Amount of time spent with you Fair	Amount of time spent with you Poor	Amount of time spent with you N/A
Explaining things in a way you could understand	Explaining things in a way you could understand Excellent	Explaining things in a way you could understand Very Good	Explaining things in a way you could understand Good	Explaining things in a way you could understand Fair	Explaining things in a way you could understand Poor	Explaining things in a way you could understand N/A
Instructions regarding medication/follow up care	Instructions regarding medication/follow up care Excellent	Instructions regarding medication/follow up care Very Good	Instructions regarding medication/follow up care Good	Instructions regarding medication/follow up care Fair	Instructions regarding medication/follow up care Poor	Instructions regarding medication/follow up care N/A
The thoroughness of the examination	The thoroughness of the examination Excellent	The thoroughness of the examination Very Good	The thoroughness of the examination Good	The thoroughness of the examination Fair	The thoroughness of the examination Poor	The thoroughness of the examination N/A
Advice given to you on ways to stay healthy	Advice given to you on ways to stay healthy Excellent	Advice given to you on ways to stay healthy Very Good	Advice given to you on ways to stay healthy Good	Advice given to you on ways to stay healthy Fair	Advice given to you on ways to stay healthy Poor	Advice given to you on ways to stay healthy N/A

Comment: (please specify)

Question Title

* 6. Your overall satisfaction with:

	Excellent	Very Good	Good	Fair	Poor	N/A
Our practice	Our practice Excellent	Our practice Very Good	Our practice Good	Our practice Fair	Our practice Poor	Our practice N/A
The quality of your medical care	The quality of your medical care Excellent	The quality of your medical care Very Good	The quality of your medical care Good	The quality of your medical care Fair	The quality of your medical care Poor	The quality of your medical care N/A
Overall rating of care from your provider	Overall rating of care from your provider Excellent	Overall rating of care from your provider Very Good	Overall rating of care from your provider Good	Overall rating of care from your provider Fair	Overall rating of care from your provider Poor	Overall rating of care from your provider N/A

Comment: (please specify)

Question Title

* 7. If you have had the opportunity to use your secure patient portal, how would you rate it's usefulness?

Excellent

Very Good

Good

Fair

Poor

N/A

Excellent

Very Good

Good

Fair

Poor

N/A

Comment: (please specify)

Question Title

* 8. Would you recommend our providers to others?

Definitely Yes

Probably Yes

Unsure

Probably No

Definitely No

Definitely Yes

Probably Yes

Unsure

Probably No

Definitely No

Comment: (please specify)

Question Title

* 1. Please identify who is your main Clinician:

Question Title

* 2. Your Appointment

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* 3. Our Staff:

Question Title

* 4. Our Communication With You:

Question Title

* 5. Your visit with the Provider:

Question Title

* 6. Your overall satisfaction with:

Question Title

* 7. If you have had the opportunity to use your secure patient portal, how would you rate it's usefulness?

Question Title

* 8. Would you recommend our providers to others?

Question Title

* 9. If there is any way we can improve our services to you, please tell us about it: