Excelsior Springs Hospital Health Express Question Title * 1. You were seen by the following Nurse Practitioner: Petisha Davis, NP Other Question Title * 2. Was this your first visit to our clinic? Yes No Question Title * 3. Would you recommend this office to your friends and family? Definitely yes Probably yes Probably no Definitely no Question Title * 4. Once you arrived your wait time was: 0-20 Minutes 21-40 Minutes Over 40 Minutes Over 60 Minutes Question Title * 5. During your visit how often did the Nurse Practitioner treat you with courtesy and respect? Always Usually Sometimes Never Question Title * 6. During your visit how often did the Nurse Practitioner listen carefully to you? Always Usually Sometimes Never Question Title * 7. During this office visit how often did the Nurse Practitioner explain things in a way you could understand? Always Usually Sometimes Never Question Title * 8. The amount of time the Nurse Practitioner spent with me was: Excellent Very Good Good Fair Poor Question Title * 9. The staff was friendly and efficient. Strongly agree Agree Disagree Strongly disagree Question Title * 10. The explanation of test(s) and treatment by the staff was: Excellent Very good Good Fair Poor Question Title * 11. I was given adequate discharge instructions. Definitely yes Mostly yes Not sure Mostly no Definitely no Question Title * 12. The cleanliness and comfort of this office was: Excellent Very good Good Fair Poor Question Title * 13. You were notified of your test results within a reasonable amount of time. Strongly agree Agree N/A Disagree Strongly disagree Question Title * 14. What one thing could we do that would most improve your office experience? Question Title * 15. Date of visit (optional) Question Title * 16. Contact information (optional) Name Phone number Email address Question Title * 17. Gender Identity (optional) Male Female Question Title * 18. Age (optional) Under 18 years 18-30 years 31-45 years 46-65 years 66 and over Question Title * 19. How did you hear about us? Internet TV ad Newspaper Family/Friend/Employer Other Thank you for taking the time to fill out our survey so that we may improve our services to our patients. Your suggestions are very important to us. If you have additional information or concerns please feel free to contact: Physician Clinic Manager 816-637-2050 Done