Pinnacle Care Internal Medicine Patient Satisfaction Survey

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* 1. My last appointment was with:

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* 2. The scheduling process was satisfactory

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* 3. I am able to call and get in touch with the office in a timely manner

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* 4. When I leave a message for the office, my call is returned within 24 hours

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* 5. The front desk staff was courteous and greeted me with a smile

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* 6. The wait in the patient lobby was:

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* 7. The check-in/check-out process was a pleasant experience

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* 8. The medical assistant staff was courteous and greeted me with a smile

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* 9. My wait in the exam room was

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* 10. My provider spent adequate time with me

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* 11. My provider was courteous, sensitive to my needs and listened to what I said

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* 12. I have confidence and trust in the provider who treated me

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* 13. My provider clearly communicated the diagnosis and treatment plan

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* 14. The appearance and neatness of the facility was excellent

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* 15. Overall, my experience was excellent

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* 16. Please share one thing you would have us change to improve your experience with us

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* 17. Please share the best thing about your visit with us

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* 18. Please name a staff member who was especially helpful or exceeded your       expectations

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* 19. Please name a staff member who may have NOT met your expectations and how they failed to do so

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* 20. Please share any additional comments related to your experience with our office

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* 21. How likely is it that you would recommend our office to a friend or colleague?

NOT AT ALL LIKELY
EXTREMELY LIKELY

T