ESC-MT PATIENT SATISFACTION SURVEY OUR FACILITY 1-4 REGISTRATION 5-7 PRE-OP 8-11 OPERATING/PROCEDURE ROOM 12-13 POST OPERATIVE/RECOVERY 14-16 OVERALL EXPERIENCE 17 Question Title * 1. Convenience of center's location Great Good Ok Fair Poor Question Title * 2. Signage and directions easy to follow Great Good Ok Fair Poor Question Title * 3. Cleanliness of center Great Good Ok Fair Poor Question Title * 4. Comfort of waiting room Great Good Ok Fair Poor Question Title * 5. Friendliness of staff Great Good Ok Fair Poor Question Title * 6. Speed of registration process Great Good Ok Fair Poor Question Title * 7. Time in waiting room Great Good Ok Fair Poor Question Title * 8. Professionalism and courtesy of pre-op staff Great Good Ok Fair Poor Question Title * 9. Appropriate & complete information given at pre-op phone call Great Good Ok Fair Poor Question Title * 10. Answered your questions and addressed your concerns Great Good Ok Fair Poor Question Title * 11. Waiting time prior to going into operating room Great Good Ok Fair Poor Question Title * 12. Professionalism and courtesy of staff (nurses/doctor) Great Good Ok Fair Poor Question Title * 13. Comfort of operating room Great Good Ok Fair Poor Question Title * 14. Professionalism and courtesy of staff Great Good Ok Fair Poor Question Title * 15. Written instructions were understandable/explained well Great Good Ok Fair Poor Question Title * 16. All questions were answered Great Good Ok Fair Poor Question Title * 17. Overall patient and family experience at Eye Surgery Center of MT? Great Good Ok Fair Poor Question Title * 18. Please circle the physician who provided care to you this visit: Doherty Shelton Wang Frenkel Gates Young Horn Everman Question Title * 19. Name (Optional): Question Title * 20. Phone Number (Optional): Question Title * 21. Date of Service (Optional): Question Title * 22. Comments: Page1 / 1 100% of survey complete. Done