Patient Satisfaction Survey

The staff at the Dermatology & Laser Center of Chapel Hill thank you for participating in this survey.  Your feedback will help us make sure we provide the best possible patient experience in our practice. Thank you!

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* 1. Please indicate the provider you would like to survey:

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* 2. What was the general purpose of your visit?

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* 3. What made you decide to choose our practice for your visit?

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* 4. When you called for your appointment, how would you rate the response from the person who answered the telephone?

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* 5. When you arrived at the office, how would you rate the Front Office Representative in the following areas?

  Excellent Good Average Fair Poor
Friendly and courteous?
Helpful?

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* 6. During your visit, how would you rate our clinic staff in the following areas?

  Excellent Good Average Fair Poor
Friendly and courteous?
Helpful/Knowledgeable?
Competent and professional?
Sympathetic and caring?

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* 7. During your visit, how would you rate the physician or physician assistant in the following areas?

  Excellent Good Average Fair Poor
Friendly and courteous?
Competent and professional?
Sympathetic and caring?

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* 8. Do you feel you were given adequate information about:

  Yes No
The overall procedure
The doctor's experience
Total fees
Possible side effects
Procedure results

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* 9. Please comment on any staff interaction and/or ideas how to improve our service. We learn the most directly from your comments, so please feel free to share without worries of offending us; our goal is to provide the highest patient experience imaginable!

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* 10. Would you like to give a patient testimonial using your first name only?

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100% of survey complete.

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