DMC Patient Experience Survey

Please tell us about your experience with us. We welcome your feedback.

Thank you for taking time to fill out this brief survey! Whether you had a wonderful experience...or something didn't quite go right...we really want to know!

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* 1. Please rate your overall satisfaction with your most recent visit with DMC Primary Care (in person or by phone/video).

Comments

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* 2. Please rate your overall satisfaction with your provider and other medical staff during your visit.

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* 3. Please rate your overall satisfaction with DMC's office staff.

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* 4. Please rate your overall satisfaction with the appointment-making process (whether you called us or self-scheduled online).

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* 5. Please let us know which of the following apply to your most recent appointment. Please select all that apply.

I had a same-day appointment.

I had a telehealth (video) appointment using DMC | CONNECT.

I had a telehealth (video) appointment but didn't use DMC | CONNECT.

I self-scheduled my appointment online.

I had an evening appointment.

None of these apply to me.

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* 6. Out of the following radio stations, please let us know one you listen to THE MOST.

WZID-FM (95.7)

WMLL-FM (96.5 "The Mill"

WFEA-AM (1370)

WGIR-FM (101.1 "Rock 101")

WOKQ-FM (97.5)

NHPR/NPR

I don't listen to any of these stations, ever.

Other (please specify)

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* 7. Where do you typically get your daily news?

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* 8. Please enter any additional comments or concerns that you may have. Please be sure to provide your contact information in the next question if you would like someone from DMC to connect with you about your feedback.

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* 9. Thank you for your feedback. If you would like to share your contact information, please do so below, especially if you would like to connect with someone from DMC about your comments..

Name

ZIP/Postal Code

Email Address

Phone Number