* 1. Who was your physician?

* 2. Please enter your appointment date.

Date:
/
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* 3. Our facility:

  excellent good average needs improvement N/A
is conveniently located?
Reception area is neat and welcoming?
Procedure room atmosphere is neat and clean?

* 4. Our billing/insurance department:

  excellent good average needs improvement N/A
My bill was easy to understand.
Staff is courteous and friendly on the phone.
Staff returns calls within a reasonable time frame.
Staff is competent in answering my insurance/billing issues or questions in a competent manner and language I can understand.

* 5. Front Office Staff:

  excellent good average needs improvement N/A
front office staff greets me in a friendly manner and registers me promptly.
Front office staff treats me with respect and courtesy.
Front office staff works with a professional and caring attitude.
The wait time is acceptable.

* 6. Procedural Staff (Nurses and Technicians):

  excellent good average needs improvement N/A
The endoscopy staff greets me in a friendly and caring manner.
The Endoscopy staff is knowledgeable about the procedures and are able to effectively communicate information to patients and family members.
The endoscopy staff made my experience as comfortable and stress free as possible
A copy of my report was given to me after the procedure.
Educational materials were made available to me.

* 7. Physician:

  excellent good average needs improvement N/A
My physician explained fully what he/she would be doing.
Physician asked questions to understand my condition.
My procedure was performed with minimal discomfort.
My physician explained the results after the procedure.

* 8. Overall Satisfaction:

  excellent good average needs improvement N/A
My privacy and the privacy of other patients is respected.
I am satisfied with the medical/clinical services provided by Wake Forest Endoscopy Center.
I would recommend Wake Forest Endoscopy Center to my friends and family.

* 9. Thank you for taking the time to complete our survey. Please leave any additional comments below.

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