Patient satisfaction survey Question Title * 1. What is your age? 18 to 35 36 to 51 52 to 70 71 or older Question Title * 2. What is your gender? Female Male Question Title * 3. How did you originally hear about us? Friend/Family Physician Northwest Quarterly Peak on the Go Internet search/reviews Facebook Other (please specify) Question Title * 4. When scheduling your appointment: Yes No Were the staff friendly? Were the staff friendly? Yes Were the staff friendly? No Any other feedback (please specify) Was the process relatively easy? Was the process relatively easy? Yes Was the process relatively easy? No Any other feedback (please specify) Were your questions answered? Were your questions answered? Yes Were your questions answered? No Any other feedback (please specify) Question Title * 5. Which provider did you have an appointment with? Dr. Jun Dr. Stenstrom Lori Schultz, FNP-BC Angela Rosc, PA-C Bryn Byers, NP-C Renee Markese, Laser Technician & Esthetician Question Title * 6. When you checked in for your appointment, was the front desk staff: Yes No friendly and courteous? friendly and courteous? Yes friendly and courteous? No competent and professional? competent and professional? Yes competent and professional? No Any other feedback (please specify) Question Title * 7. How many minutes after your scheduled appointment time were you seen by the provider? 0-15 minutes 16-30 minutes 30+ minutes Question Title * 8. During your appointment, did you find the provider to be: Yes No friendly and courteous? friendly and courteous? Yes friendly and courteous? No competent and professional? competent and professional? Yes competent and professional? No sympathetic and caring? sympathetic and caring? Yes sympathetic and caring? No Any other feedback (please specify) Question Title * 9. How likely is it that you would recommend your provider to a friend or family? Very likely Moderately likely Not at all likely Question Title * 10. Overall, how satisfied were you with the following: Extremely satisfied Satisfied Unsatisfied level of service from our billing staff level of service from our billing staff Extremely satisfied level of service from our billing staff Satisfied level of service from our billing staff Unsatisfied level of service from our scheduling staff level of service from our scheduling staff Extremely satisfied level of service from our scheduling staff Satisfied level of service from our scheduling staff Unsatisfied level of service from our front desk staff level of service from our front desk staff Extremely satisfied level of service from our front desk staff Satisfied level of service from our front desk staff Unsatisfied level of service from our clinical support staff level of service from our clinical support staff Extremely satisfied level of service from our clinical support staff Satisfied level of service from our clinical support staff Unsatisfied level of service from our provider level of service from our provider Extremely satisfied level of service from our provider Satisfied level of service from our provider Unsatisfied condition of our lobby/waiting area condition of our lobby/waiting area Extremely satisfied condition of our lobby/waiting area Satisfied condition of our lobby/waiting area Unsatisfied Done