Cedar Park Pediatric & Family Medicine Patient Satisfaction Survey - 2015

Question Title

* 1. How would you rate your experience with the front desk staff in terms of overall patient service?

Excellent

Very Good

Fair

Poor

Additional Comments? Would you like to recognize someone from our front desk staff?

Question Title

* 2. How would you rate your waiting time in our clinic?

Excellent

Very Good

Fair

Poor

Additional Comments:

Question Title

* 3. How would you rate your experience with our clinical staff in terms of overall patient care?

Excellent

Very Good

Fair

Poor

Additional Comments? Would you like to recognize someone from our clinical staff?

Question Title

* 4. How would you rate the provider's overall level of patient care?

Excellent

Very Good

Fair

Poor

Additional Comments? Would you like to recognize one of our providers?

Question Title

* 5. Would you be willing to provide a short testimonial about your experience with Cedar Park Pediatric & Family Medicine? If yes, please let us know how we can contact you.

Yes, contact me by e-mail

Yes, contact me by phone

No, not today

Please provide your name, e-mail address or phone number where you can be reached

Question Title

* 6. Would you like to provide any additional comments, compliments or feedback?

We truly value our patients at Cedar Park Pediatric & Family Medicine and appreciate you for taking the time to share your feedback with us today.