We thank you in advance for completing this questionnaire. Your thoughts and opinions are important to us. Please place a check in the column that best describes your experience. Space is also provided for you to comment on your experience at the end of the survey. When you have finished, please mail it in the enclosed envelope.

* 1. Registration

  Very Good Good Fair Poor Very Poor
If you spoke with the Cancer Center by phone, courtesy of the person you spoke with.
Courtesy of person at registration window
Ease of registration process

* 2. Facility

  Very Good Good Fair Poor Very Poor
Cleanliness of the facility
Ease of finding your way around
Comfort of the waiting room

* 3. Radiation Therapy

  Very Good Good Fair Poor Very Poor
Wait time for your scheduled radiation treatment time
Staff concern for your comfort during your radiation therapy
Staff courtesy during your radiation therapy

* 4. Oncologist (Physician)

  Very Good Good Fair Poor Very Poor
Doctor's discussion of your treatment options
Amount of time your doctor spent with you
How well your doctor kept you informed about your condition and treatment plan
Doctor's concern for your questions and worries
Skill and knowledge of the doctor

* 5. Please share any comments regarding your experience at Bay Regional Cancer Center:

* 6. Patients Name(Optional)

* 7. Telephone number(optional)