Excision/ED&C Patient Satisfaction Survey

Please help us to continue to improve the care we provide by completing the following brief survey. We welcome your comments and encourage you to let us know how we are doing.  Your feedback is very important to us!

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* 1. Please rate the following:

  POOR FAIR GOOD EXCELLENT N/A
Was your surgery schedule in a timely manner?
Did you receive sufficient and clear pre-operative information?
Did you understand your diagnosis?
Were clear treatment options given?
Did you feel like a partner in making your healthcare decisions?
Was the planned surgical procedure explained clearly for your understanding?
Were you comfortable during your procedure in the operating room?
Were issues concerning insurance coverage, pre-certification and any expected payments handled to your satisfaction?
Were you happy with the results of your surgical procedure?

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* 2. Any comments to improve our office and make your experience better is greatly appreciated!!

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* 3. Name: (optional)

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