* 1. Overall, how satisfied were you with your last visit with us?

* 2. Which provider did you see for your appointment?

* 3. Overall, how would you rate the service of the front desk staff during your appointment experience.

* 4. Overall, how would rate the service of the medical assistant during your appointment experience.

* 5. How was your wait time today?  (Wait time includes time spent in the waiting room and exam room.)

* 6. Overall, how would you rate the care you received from your provider?

* 7. How well does your provider listen to you?

* 8. In general, how thoroughly are your treatment options explained to you during an appointment with your provider?

* 9. If you received Imaging or Labs how satisfied where you? 

* 10. Do you have any other comments, questions, or concerns?

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