Patient Satisfaction Survey

Question Title

* 1. On a scale from 1 (very dissatisfied) to 5 (very satisfied), please rate your satisfaction with your orthopedic care experience with Dr. Rice

	Very dissatisfied	Dissatisfied	Neutral	Satisfied	Very Satisfied	N/A
Appointment availability	Appointment availability Very dissatisfied	Appointment availability Dissatisfied	Appointment availability Neutral	Appointment availability Satisfied	Appointment availability Very Satisfied	Appointment availability N/A
Timeliness of getting into the office for an appointment	Timeliness of getting into the office for an appointment Very dissatisfied	Timeliness of getting into the office for an appointment Dissatisfied	Timeliness of getting into the office for an appointment Neutral	Timeliness of getting into the office for an appointment Satisfied	Timeliness of getting into the office for an appointment Very Satisfied	Timeliness of getting into the office for an appointment N/A
Timeliness of being seen by Dr. Rice in the office	Timeliness of being seen by Dr. Rice in the office Very dissatisfied	Timeliness of being seen by Dr. Rice in the office Dissatisfied	Timeliness of being seen by Dr. Rice in the office Neutral	Timeliness of being seen by Dr. Rice in the office Satisfied	Timeliness of being seen by Dr. Rice in the office Very Satisfied	Timeliness of being seen by Dr. Rice in the office N/A
Friendliness of office staff	Friendliness of office staff Very dissatisfied	Friendliness of office staff Dissatisfied	Friendliness of office staff Neutral	Friendliness of office staff Satisfied	Friendliness of office staff Very Satisfied	Friendliness of office staff N/A
Knowledge and expertise of Dr. Rice	Knowledge and expertise of Dr. Rice Very dissatisfied	Knowledge and expertise of Dr. Rice Dissatisfied	Knowledge and expertise of Dr. Rice Neutral	Knowledge and expertise of Dr. Rice Satisfied	Knowledge and expertise of Dr. Rice Very Satisfied	Knowledge and expertise of Dr. Rice N/A
Knowing that Dr. Rice cares about your problem	Knowing that Dr. Rice cares about your problem Very dissatisfied	Knowing that Dr. Rice cares about your problem Dissatisfied	Knowing that Dr. Rice cares about your problem Neutral	Knowing that Dr. Rice cares about your problem Satisfied	Knowing that Dr. Rice cares about your problem Very Satisfied	Knowing that Dr. Rice cares about your problem N/A
Postoperative rehabilitation	Postoperative rehabilitation Very dissatisfied	Postoperative rehabilitation Dissatisfied	Postoperative rehabilitation Neutral	Postoperative rehabilitation Satisfied	Postoperative rehabilitation Very Satisfied	Postoperative rehabilitation N/A
Your Overall Outcome after Surgery	Your Overall Outcome after Surgery Very dissatisfied	Your Overall Outcome after Surgery Dissatisfied	Your Overall Outcome after Surgery Neutral	Your Overall Outcome after Surgery Satisfied	Your Overall Outcome after Surgery Very Satisfied	Your Overall Outcome after Surgery N/A
Your overall health and fitness after receiving care from Dr. Rice compared to before seeing him	Your overall health and fitness after receiving care from Dr. Rice compared to before seeing him Very dissatisfied	Your overall health and fitness after receiving care from Dr. Rice compared to before seeing him Dissatisfied	Your overall health and fitness after receiving care from Dr. Rice compared to before seeing him Neutral	Your overall health and fitness after receiving care from Dr. Rice compared to before seeing him Satisfied	Your overall health and fitness after receiving care from Dr. Rice compared to before seeing him Very Satisfied	Your overall health and fitness after receiving care from Dr. Rice compared to before seeing him N/A

Question Title

* 2. Based on your experience, if you had to make the choice again, would you seek care from Dr. Rice?

Yes

No

Question Title

* 3. If you answered no to Question 2, why not?

Question Title

* 4. Please provide any other comments, feedback, or suggestions you would like to share: