* 1. How easy was it to get through to our office on the phone?

* 2. How friendly or courteous was the staff scheduling your initial appointment?

* 3. How friendly or courteous was the staff who scheduled your procedure?

* 4. Name of the physician who performed your procedure.

* 5. Procedure: Rate your Physician.

* 6. Rate the nurses who cared for you during your procedure.

* 7. Rate the Reception Staff.

* 8. Post Procedure: Were the results and discharge instructions explained satisfactorily?

* 9. How do you feel about the length of time you spent at Advanced Endoscopy for your procedure?

* 10. If too long, tell us how we can do better.

* 11. How likely are you to recommend us to others?

* 12. Did you feel safe while at the center?

* 13. If not, please let us know how to improve your safety.

* 14. How did you learn about our medical practice?

* 15. Comments:

* 16. If you would like us to contact you regarding your experience, please indicate so. Also, please list your contact information on the next question.

Please note, surveys are only sent to the office one time per month, so if this is an urgent request for response, please call our office directly at 360-576-5060.

* 17. Optional: list your contact information here:

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