Exit this survey

1.

1. Date of Visit:

2. Care Provider / Department

3. Which BCM facility did you visit?

4. For your appointment, was the scheduling process easy?

5. When you scheduled your appointment for today, was the scheduling agent courteous?

6. When you arrived at the front desk, were you greeted with "Welcome to Baylor College of Medicine, I can help you" or by your name?

7. Was the front desk staff courteous?

8. Did you receive adequate information in regards to delays?

9. Did the nurses/technicians introduce themselves by name?

10. Were the nurses/technicians friendly and courteous?

11. Did the nurses/technicians provide necessary information on the day of your procedure or test?

12. Did the nurses/technicians provide proper instructions about caring for yourself at home?

13. Do you have confidence in the skills of the nurses/technicians?

14. Do you have confidence in the skills of the physician?

15. Overall, were you satisfied with the care you received?

16. Would you recommend our facility to others?

17. Tell us more about how we can improve which will help us better care for you and other BCM patients.

18. Is there anyone you would like to recognize for providing outstanding service or care?

19. Would you like someone to contact you?

20. If yes, your name:

21. Preferred method to be contacted:

22. Phone number or email:

23. Best time to contact you by phone:

Thank you for your feedback.

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