BROC Patient Satisfaction Survey

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* 1. Please select your physician for this visit

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* 2. Please select your mid-level provider for this visit (if applicable)

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* 3. How did you first hear about BROC- Baton Rouge Orthopaedic Clinic

Referral from a provider

Billboard Ad

Google Search

Social Media (Facebook, Instagram, etc.)

Word of Mouth (Friend/Family Member)

Radio Ad

Print (Business Report, 225 Magazine, etc.)

Community Events (High School Sports, etc.)

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

Extremely convenient

Very convenient

Somewhat convenient

Not so convenient

Not at all convenient

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

Excellent

Very good

Good

Fair

Poor

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

Extremely comfortable

Very comfortable

Somewhat comfortable

Not so comfortable

Not at all comfortable

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

Very early

Somewhat early

On time

Somewhat late

Very late

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* 9. How much do you trust your provider to make medical decisions that are in your best interests?

A great deal

A lot

A moderate amount

A little

Not at all

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* 10. How well did your provider explain your treatment options?

Extremely well

Very well

Somewhat well

Not so well

Not at all well

BROC Patient Satisfaction Survey

Question Title

* 1. Please select your physician for this visit

Question Title

* 2. Please select your mid-level provider for this visit (if applicable)

Question Title

* 3. How did you first hear about BROC- Baton Rouge Orthopaedic Clinic

Question Title

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

Question Title

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

Question Title

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

Question Title

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

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

Question Title

* 9. How much do you trust your provider to make medical decisions that are in your best interests?

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* 10. How well did your provider explain your treatment options?

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* 11. Is there anything we could have done to improve your last visit?

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* 12. Please provide any comments or suggestions regarding your experience at BROC.