In order to provide your patients with the best possible retinal care, it is important for us to know your thoughts regarding our ability to meet your needs. Your time and opinions are appreciated. This survey can be anonymous or if prefer follow-up, please fill out your practice contact info. 
Thanks in advance for your feedback!

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* 1. Please identify your specialty of practice.

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* 2. Are your patients able to schedule an appointment with a Colorado Retina Associates (CRA) physician within 72 hours of the initial referral?

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* 3. Is your office able to easily schedule a same day add-on patient with a CRA physician when needed?

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* 4. Are you satisfied with the ease of ability to reach the CRA office?

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* 5. When you contact our office how long were you on hold?

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* 6. When you spoke with someone in our call center, what was your impression of their temperament?

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* 7. Are you satisfied with the turn-around-time to resolve your request/concern?

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* 8. Are you satisfied with our triage services and after-hours emergent services provided by our 24/7 on-call physician?

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* 9. We are working to improve our triage services and add the opportunity for you to “curbside consult” directly with a CRA provider:
i.e. Review a potential retinal finding/image/diagnostic testing results, or ask a retina-related question quickly by text, call or email.

Would you utilize this service and find it beneficial?

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* 10. Are you satisfied with your practice’s overall professional and patient relationship with CRA?

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* 11. My patients seem to have a good overall experience with the CRA physicians and support staff.

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* 12. I receive CRA’s consultation reports in a timely manner.

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* 13. Amount of communication received around consultation reports after each patient visit at CRA.

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* 14. How can we improve or what can we do differently to make referring patients to our office easier, more efficient, and more convenient for you and your staff?

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* 15. Would you find a portal helpful for your staff to track all sent referrals and create further transparency in where your referred patients are in their journey with CRA? (i.e. see when they were called/left messages, with whom and where they were scheduled, review progress reports, etc.)

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* 16. Would you find self-scheduling beneficial?
Would you like the ability to schedule a patient with your preferred CRA physician before they leave your office?

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* 17. How do you prefer to be contacted about your patients? Check all that apply.

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* 18. Would you be interested in a retina-education accredited CE or JCAHPO course over the lunch hour for you and your fellow providers and/or support staff?

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* 19. How does your overall experience with Colorado Retina Associates affect your office’s desire to continue referring patients to us?

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* 20. If you are no longer referring patients to Colorado Retina Associates, please specify the reason. Check all that apply.

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* 21. Please leave us additional feedback on services you would like to see added, requested policy revisions or clarifications needed, changes you would like made to the referral process, scheduling concerns, and/or any other requests/comments you have to help us better serve you.

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* 22. This survey is meant to be anonymous, however, if you would like followup or to help us identify you as a practice we need to improve with please leave us your contact information.

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