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2026 Clinic Satisfaction Survey

2026 Multidisciplinary Clinic Satisfaction Survey

The ALS Association serving Florida is interested in learning about your experience with the care and services you have received from the Association and the ALS Multidisciplinary Clinics in Florida. Your feedback is important to help us identify opportunities for improvement to serve you better. This short survey will take you approximately 5-10 minutes to complete. Thank you for participating in this survey!
1.Please select which applies to you:(Required.)
2.Please select which applies to you:(Required.)
3.Please confirm the Clinic you attend.(Required.)
4.Please rate your level of satisfaction with the following experiences during your clinic visits within the last year.(Required.)
very satisfied
satisfied
neutral
dissatisfied
very dissatisfied
The process of scheduling clinic visits.
Response to concerns/questions made during your visit.
The courtesy and respect shown to you and your family by the staff.
Follow up after clinic visit (e.g. prescriptions, equipment orders, resources).
The clinic staff collaborated to provide comprehensive care for you.
Your overall satisfaction with your clinic visits.
5.Please mark your level of agreement with the following statements about your clinic visits.(Required.)
strongly agree
agree
neutral
disagree
strongly disagree
The staff was knowledgeable about my condition and status during the visit.
The expectations I had about attending clinic were met.
6.What do you like about your clinic visit experience?(Required.)
7.Please provide comments/suggestions to help improve your clinic visit experience.(Required.)
8.Please provide your name/email (optional):