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How satisfied are you with the following?

Please choose one for each of the following questions:

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* 1. Service this survey is about

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* 2. Which provider are you completing this survey about?

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* 3. Ease of making appointment for checkups (physical exams, well visits, routine follow-up appointments)?

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* 4. Ease of making appointments for sickness/dental emergency?

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* 5. Ease of contacting your doctor when our office is closed (nights and weekends)?

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* 6. The time it takes someone from our office to respond when you call the office?

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* 7. Waiting time in our office?

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* 8. Ease of obtaining follow-up information and care (test results, medicines, care instructions)

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* 9. Overall care during your appointment?

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* 10. Our office's appearance?

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* 11. Our office's convenience (location, parking, hours, office layout)?

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* 12. The way we teach you about improving your health?

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* 13. The way your doctor involves other doctors and caregivers in your care when needed?

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