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Patient Satisfaction Survey 

1.Our records show that you recently received care from Williamson Gynecology.  Please choose the provider that you saw during this visit:
2.Is Williamson Gynecology the provider you usually see if you need a check-up, want advice about a health problem, or get sick or hurt?
3.How long have you been going to Williamson Gynecology?
4.In the last 12 months, how many times did you visit Williamson Gynecology?
5.For your most recent appointment, did you contact Williamson Gynecology’s office to get an appointment for an illness, injury, or condition that needed care right away or to get an appointment for a check-up or routine care?
6.When you contacted Williamson Gynecology’s office to get the appointment referenced in question 5, was your appointment scheduled within a reasonable time?
7.In the last 12 months, have you contacted Williamson Gynecology’s office with a medical question during regular office hours?
8.If you have contacted Williamson Gynecology's office with medical question during regular business office hours, how often did you get an answer to your medical question on the same day?
9.In the past 12 months, how often were you able to get the care you needed during evenings, weekends or holidays?
10.Wait time includes time spent in the waiting room and exam room. How long was your wait time for your most recent visit?
11.During your most recent visit, did your healthcare provider explain things in a way that was easy to understand?
12.During your most recent visit, did your healthcare provider listen carefully to you?
13.During your most recent visit, did you talk with your healthcare provider about any health questions, health concerns and/or health goals?
14.During your most recent visit, did your healthcare provider give you easy to understand information about these health questions, concerns and/or goals?
15.During your most recent visit, did your healthcare provider seem to know the important information about your medical history?
16.During your most recent visit, did your healthcare provider show respect for what you had to say?
17.During your most recent visit, did your healthcare provider spend enough time with you?
18.During your most recent visit, did your healthcare provider order a blood test, x-ray, or other test for you?
19.If additional testing was ordered, did someone from Williamson Gynecology’s office follow up to give you those results?
20.Using any number from 0 to 10, where 0 is the worst provider possible and 10 is the best provider possible, what number would you use to rate your healthcare provider?
10 Best provider possible
9
8
7
6
5
4
3
2
1
0 Worst provider possible
.
21.Would you recommend Williamson Gynecology’s office to your family and friends?
22.During your most recent visit, were clerks and receptionists at Williamson Gynecology’s office as helpful as you thought they should be?
23.During your most recent visit, did clerks and receptionists at Williamson Gynecology’s office treat you with courtesy and respect?
24.In general, how would you rate your overall health?
25.In general, how would you rate your overall mental or emotional health?
26.What is your age?
27.What is your race? Mark one or more.
28.Did someone help you complete this survey?
29.How did that person help you? Mark one or more.
30.This survey is anonymous. If you would like a return call concerning your appointment, please enter your name and contact information and someone will contact you.