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

Not at all likely
Extremely likely

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

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

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* 4. Which Danville Polyclinic provider do you receive care from?

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* 5. The efficiency of the check-in process

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* 6. Keeping you informed if your appointment time was delayed

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* 7. The friendliness and courtesy of the receptionist

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

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

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

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

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

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* 13. The professionalism of our Lab and Radiology staff

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

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* 15. Overall, are you satisfied or dissatisfied with the customer service you received from the Medical Records staff?

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

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

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* 18. The helpfulness and knowledge of our Business Office regarding your account questions

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* 19. Your phone call or message regarding your account was answered in a timely manner

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* 20. The Business Office adequately explained your account options

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

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* 22. What changes would most improve our service?

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

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* 24. 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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