* 1. Our records indicate that you got care from Delo Medical Associates in the last 12 months. Who did you receive care from?

* 2. Is your healthcare provider 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 your healthcare provider?

* 4. In the last 12 months, how many times did you visit your healthcare provider?

* 5. In the last 12 months, did you phone your healthcare provider’s office to get an appointment for an illness, injury, or condition that needed care right away?

* 6. In the last 12 months, when you phoned your healthcare provider’s office to get an appointment for care you needed right away, how often did you get an appointment as soon as you needed?

* 7. In the last 12 months, did you make any appointments for a check-up or routine care with your healthcare provider?

* 8. In the last 12 months, when you made an appointment for a check-up or routine care with this provider, how often did you get an appointment as soon as you needed?

* 9. In the last 12 months, did you phone your healthcare provider’s office with a medical question during regular office hours?

* 10. In the last 12 months, when you phoned your healthcare provider’s office during regular office hours, how often did you get an answer to your medical question that same day?

* 11. In the last 12 months, did you phone your healthcare provider’s office with a medical question after regular office hours?

* 12. In the last 12 months, when you phoned your healthcare provider’s office after regular office hours, how often did you get an answer to your medical question as soon as you needed?

* 13. Wait time includes time spent in the waiting room and exam room. During your most recent visit, did you see your healthcare provider within 15 minutes of your appointment time?

* 14. In the last 12 months, how often did your healthcare provider explain things in a way that was easy to understand?

* 15. In the last 12 months, how often did your healthcare provider listen carefully to you?

* 16. In the last 12 months, did you talk with your healthcare provider about any health questions or concerns?

* 17. In the last 12 months, how often did your healthcare provider give you easy to understand information about these health questions or concerns?

* 18. In the last 12 months, how often did your healthcare provider seem to know the important information about your medical history?

* 19. In the last 12 months, how often did your healthcare provider show respect for what you had to say?

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