* 1. Which provider did you visit?

* 2. Overall, how easy do you find it to schedule appointments?

* 3. Ease of registration and check-in process:

* 4. Wait time includes time spent in the waiting room and exam room. During your most recent visit, how would you rate your wait time?

* 5. The courtesy and respect of our team:  receptionists, medical assistants, sonographers, providers, billing staff:

* 6. Communication by the office:  during phone calls, giving test results, explanation and answering questions:

* 7. Overall, how satisfied or dissatisfied are you with our office?

* 8. How did you hear about us?

* 9. Where do you feel we have room for improvement?

* 10. Please use the space provided below for any additional comments.

T