Medical Patient Satisfaction Survey
200%
1.
Which site did you visit today?
Bermuda Medical Center
Greater Fulton Medical Center
Northside Medical Center
Pediatric Medical Center
Southside Medical Center
Vernon J. Harris Medical Center
Wellness Center
2.
Ability to obtain an appointment soon enough to meet your medical needs
Excellent
Good
Fair
Poor
N/A
Excellent
Good
Fair
Poor
N/A
3.
Courteous and professional treatment by Front Desk Staff
Excellent
Good
Fair
Poor
N/A
Excellent
Good
Fair
Poor
N/A
4.
Time waiting in the office to see your Doctor
Excellent
Good
Fair
Poor
N/A
Excellent
Good
Fair
Poor
N/A
5.
Courteous and professional treatment by Provider
Provider
Rating
Provider
-- Select an option --
Dr. Brooks-Williams
Claudia Altman
Dr. Brown
Mallory Cain
Dr. Forth
Dr. Carol Williams Hardcastle
Dr. Jennings
Dr. Vicki Lovings
Dr. Marilyn Meyer
Diana Osorio
Saima Panjwani
Seleste Upshaw
Carla Sanders
Jessica Tate
Nicole Cole
Anitra Brown-Evans
Leslie Ramsay
-- Select an option --
Excellent
Good
Fair
Poor
N/A
6.
Courteous and professional treatment by Nurse
Excellent
Good
Fair
Poor
N/A
Excellent
Good
Fair
Poor
N/A
7.
Rate your understanding of your diagnosis and treatment instructions provided by your care team
Excellent
Good
Fair
Poor
N/A
Excellent
Good
Fair
Poor
N/A
8.
Availability of patient education information, such as Medication, Adherence, Prevention, etc.
Excellent
Good
Fair
Poor
N/A
Excellent
Good
Fair
Poor
N/A
9.
The cleanliness of our facility
Excellent
Good
Fair
Poor
N/A
Excellent
Good
Fair
Poor
N/A
10.
Overall satisfaction with care provided
Excellent
Good
Fair
Poor
N/A
Excellent
Good
Fair
Poor
N/A
11.
How affordable were the medical services your received?
Extremely affordable
Very affordable
Somewhat affordable
Not so affordable
Not at all affordable
12.
How did you hear about CAHN?
Radio
TV (CW/Fox)
Friend
Internet
Health Fair/Outreach Event
Good News USA
Key Awareness
Insurance
Other (please specify)
13.
Type of Appointment?
Scheduled
Walk-in
Televisit
14.
Are you male or female?
Male
Female
Transgender Male/Female to Male
Transgender Female/Male to Female
Other
Chose not to disclose
15.
What mode of transportation did you use?
CAHN's Transportation
Car
GRTC
Walk
Insurance
Other
Other (please specify)
16.
Are you aware of available transportation options?
Yes
No
If yes, through Capital Area Health Network
If yes, through your insurance company
17.
In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305)
18.
What is your ethnicity? (Please select all that apply.)
American Indian or Alaskan Native
Asian or Pacific Islander
Black or African American
Hispanic or Latino
White / Caucasian
Prefer not to answer
Other (please specify)
19.
In the last 12 months, did you phone your healthcare provider’s office with a medical question after regular office hours?
Yes
No
20.
In the last 12 months, when you phoned your healthcare provider’s office after regular office hours, how often did you get an answer to your medical question as soon as you needed?
Never
Sometimes
Usually
Always
N/A
21.
In the last 12 months, were you able to obtain a same-day appointment when needed for urgent care?
Yes
No
N/A
22.
Preferred Hours of Operations:
6 am - 3 pm
7 am - 4 pm
8 am - 9 pm
8 am - 11 pm
Saturday
23.
On a scale of 0 to 10,
How likely is it that you would recommend CAHN to a friend or colleague?
0 for Not at all likely, 10 for Extremely likely
Not at all likely
Extremely likely
0
1
2
3
4
5
6
7
8
9
10
24.
Do you have any other comments, questions, or concerns?
