* 1. At which of our centers are you most frequently seen?

* 2. When I call to get an appointment, I am able to get an appointment as soon as I need one.

* 3. When I call the office during office hours, I get an answer to my medical questions that day.

* 4. My provider listens to my concerns and questions.

* 5. All medical center staff treats me with respect and care.

* 6. When my provider orders blood tests, x-rays, or other tests, the office follows up to give me the results.

* 7. In the last 12 months, how often did someone in the practice talk to you about specific goals for your health?

* 8. How likely are you to recommend this office to your family and friends?

* 9. What is your age?

* 10. What is the highest degree or level of school you have completed?

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