1.How would you rate your experience with the process of scheduling appointments at our office and appointment availability?

Excellent

Good

Average

Poor

2.How satisfied are you with the wait time during your visits?

Very satisfied

Satisfied

Neutral

Dissatisfied

Very dissatisfied

3.How would you rate the cleanliness of our facility (lobby, rooms, bathrooms, etc)?

Very clean

Clean

Average

Below average

Not clean

4.Do our office hours of M/W/Th 8AM - 7PM and T/F 8AM - 5PM, work well for your family?

Always

Most of the time

Sometimes

Rarely

Never

5.How would you rate the helpfulness of our after-hours line?

Very helpful

Helpful

Neutral

Unhelpful

Very unhelpful

6.How easy is it to reach our office by phone?

Very easy

Easy

Neutral

Difficult

Very difficult

7.How would you rate your experience with our billing department?

Excellent

Good

Average

Poor

8.Which aspects of our service do you find most satisfactory? Select all that apply.

Appointment scheduling

Wait time

Facility cleanliness

Office hours

Providers

Triage Staff

Nurses

Front Office Staff

9.Is there any specific employee you would like to recognize for their exceptional service?

10.Please enter your first and last name below.