As a patient of ours, your opinion is very important to us. Our team's goal is to provide an exceptional experience for each patient. Your input will help us to continuously improve the quality of our patients' healthcare. 

* 1. Physician Name

* 2. Location

* 3. On a scale from 1-5, 1 being the worst care and 5 the best possible care, what number would you use to rate your healthcare provider?

* 4. During your most recent visit, did your healthcare provider give you easy to understand information about your questions or concerns?

* 5. Would you recommend your healthcare provider's office to your friends and family?

* 6. Please rate your experience with the following. 1 = Very Poor and 5 = Excellent. Select N/A if not applicable

  1 2 3 4 5 N/A
Telephone Answering Service
Scheduling Your Appointment
Front Desk Reception Area
Physician's Staff
Imaging Services
Billing Department

* 7. How easy or difficult was it to schedule your appointment at a time that was convenient for you?

* 8. How was the length of time waiting in the office?

* 9. Overall on a scale from 1-5 with 1 being the least and 5 being the most, how satisfied are you as our patient?

* 10. Please leave any additional comments here. Thank you for completing our survey.