Which provider did you visit?

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* 1. Which provider did you visit?

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

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

Ease of registration and check-in process:

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

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

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* 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?

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

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

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

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

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

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

How did you hear about us?

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* 8. How did you hear about us?

Where do you feel we have room for improvement?

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

Please use the space provided below for any additional comments.

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

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