* 1. How likely is it that you would recommend your provider to a friend or family member?

Not at all likely
Extremely likely

* 2. Overall, how satisfied or dissatisfied were you with your last visit to our office?

* 3. Does the website appear easy to navigate?

* 4. How easy or difficult was it to schedule your appointment at a time that was convenient for you?

* 5. How convenient was the appointment time you were able to get?

* 6. In your opinion, how convenient is the location of our office?

* 7. Overall, how would you rate the service you received from the staff at our office?

* 8. How comfortable was the lobby and waiting area?

* 9. Did your appointment with your provider start early, late or on time?

* 10. Overall, how would you rate the care you received from your nursing staff?

* 11. How well did your provider answer your questions?

* 12. How well did your provider explain your follow-up care?

* 13. How helpful are the employees at Danville Polyclinic?

* 14. How professional are the employees at Danville Polyclinic?

* 15. How would you rate the quality of the healthcare you received??

* 16. Overall, how satisfied or dissatisfied are you with Danville Polyclinic?

* 17. What do you like most about Danville Polyclinic?

* 18. What changes would most improve our service?

* 19. Please describe any dissatisfaction you experienced at Danville Polyclinic in more detail.

* 20. Which Danville Polyclinic providers do you receive care from?

* 21. Please feel free to include your name & contact information in the comment box.

Thank you for taking this patient satisfaction survey.
Your healthcare is extremely important to us.

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