Patient Satisfaction Survey-Chest Center

This brief patient satisfaction survey is for persons who received services in any of The City of New York Chest Center Clinics. The New York City Department of Health and Mental Hygiene wants to know how well they are satisfying their patients and where they should make improvements. Your honest feedback is very important.

Please be assured that your individual responses to the survey will be confidential and will only be shared with the New York City Department of Health and Mental Hygiene for the purposes of improving the quality of patient care and not for sales, marketing or fund raising. The goal of this survey is to improve services for patients.

As we go through the survey, please rate your experiences in this clinic only during your most recent visit, even if you had other services. Let’s begin.

* 1. Date visited:

* 2. Clinic visited:

* 3. How satisfied were you with the care each service provided?

  Very Moderately Unsatisfied Not Received
TB Test
HIV Test
Chest X-ray
Blood work
Social Worker
Sputum induction
Clerical Staff

* 4. How long did you wait between the time of registration and the time you were first seen by a healthcare provider? Would you say...

* 5. Was there a delay of more than 30 minutes from your appointment time to the time you received the first service (includes registration)?

* 6. Did you get updates from staff regarding reason(s) for service delays?

* 7. Did you find the following area(s) clean:

  Yes No Don't Know Not Applicable
Waiting area(s)?
Examination room(s)?

* 8. If you were given medication at this visit, did the doctor or nurse explain how to take it, side effects, and reason for prescribing it?

* 9. If you received language services, were you satisfied?

* 10. Thinking of this visit, what could the Chest Center Clinic have done better?

* 11. How often was the patient care staff able to address your fears or concerns? Would you say...

* 12. Using any number from 0 to 10, where 0 is the worst clinic possible and 10 is the best clinic possible, what number would you use to rate this clinic?

* 13. Would you recommend this clinic to your friends and family? Would you say...

Thank you for your time and for helping us serve you better!