Please Select the location of your most recent visit:

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* 1. Please Select the location of your most recent visit:

When you made your most recent appointment with Horizon Family Medical Group, were we able to meet your date and time preference?

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* 2. When you made your most recent appointment with Horizon Family Medical Group, were we able to meet your date and time preference?

What is your Age? 

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* 3. What is your Age? 

Were your expectations met during your last visit?

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* 4. Were your expectations met during your last visit?

How satisfied were you with the courteousness/friendliness of our front desk during your visit?

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* 5. How satisfied were you with the courteousness/friendliness of our front desk during your visit?

How satisfied were you with the courteousness/friendliness of our nurses during your visit?

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* 6. How satisfied were you with the courteousness/friendliness of our nurses during your visit?

How satisfied were you with the time you waited before you were seen by your provider?

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* 7. How satisfied were you with the time you waited before you were seen by your provider?

How satisfied were you with the courteousness/caring of your provider during your visit?

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* 8. How satisfied were you with the courteousness/caring of your provider during your visit?

How well did your doctor listen to you during your visit?

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* 9. How well did your doctor listen to you during your visit?

How well did your doctor explain how to take your medicine(s)?

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* 10. How well did your doctor explain how to take your medicine(s)?

How satisifed were you with the self-care management tools given to you at your appointment?
(example: patient literature,referral information, classes)

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* 11. How satisifed were you with the self-care management tools given to you at your appointment?
(example: patient literature,referral information, classes)

How satisfied overall are you with the level of care you received during your last visit?

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* 12. How satisfied overall are you with the level of care you received during your last visit?

Did any Horizon staff member make your visit/interaction today extra special or meaningful? If so, please indicate the name of the person:

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* 13. Did any Horizon staff member make your visit/interaction today extra special or meaningful? If so, please indicate the name of the person:

Do you ever recommend Horizon Family Medical Group to family and friends?

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* 14. Do you ever recommend Horizon Family Medical Group to family and friends?

What, if anything, would you like to see done differently or what could be done to improve the service you received from Horizon Family Medical Group?

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* 15. What, if anything, would you like to see done differently or what could be done to improve the service you received from Horizon Family Medical Group?

If you were referred to a specialist, did your primary care provider explain to you why you were being referred to a specialist?

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* 16. If you were referred to a specialist, did your primary care provider explain to you why you were being referred to a specialist?

If you were referred to a specialist, did the specialist have all your necessary health history information, such as lab or x-ray results and your medication list prior to your arrival?

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* 17. If you were referred to a specialist, did the specialist have all your necessary health history information, such as lab or x-ray results and your medication list prior to your arrival?

If you were referred to a specialist, did they communicate their findings back to your primary care doctor? Basically did you get a sense that the two doctors were communicating with each other?

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* 18. If you were referred to a specialist, did they communicate their findings back to your primary care doctor? Basically did you get a sense that the two doctors were communicating with each other?

For patients who were hospitalized within the past 12 months: Did the Horizon care transition RN visit you and advocate for you during your hospital stay?

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* 19. For patients who were hospitalized within the past 12 months: Did the Horizon care transition RN visit you and advocate for you during your hospital stay?

For patients who were hospitalized within the past 12 months: When you left the hospital, did you know how to reach the Horizon care transition RN with any questions or concerns?

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* 20. For patients who were hospitalized within the past 12 months: When you left the hospital, did you know how to reach the Horizon care transition RN with any questions or concerns?

For patients who were hospitalized within the past 12 months: Did you receive a call from your Horizon care transition RN to discuss your discharge instructions and medications?

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* 21. For patients who were hospitalized within the past 12 months: Did you receive a call from your Horizon care transition RN to discuss your discharge instructions and medications?

For patients who were hospitalized within the past 12 months: Did you know that the Horizon care transition RN is available post hospital discharge for any questions or concerns?

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* 22. For patients who were hospitalized within the past 12 months: Did you know that the Horizon care transition RN is available post hospital discharge for any questions or concerns?

For patients who were hospitalized within the past 12 months: Did the Horizon care transition RN schedule your follow up appointment post discharge?

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* 23. For patients who were hospitalized within the past 12 months: Did the Horizon care transition RN schedule your follow up appointment post discharge?

Have you visited your (PCP) Primary Care Provider this year for your annual physical?

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* 24. Have you visited your (PCP) Primary Care Provider this year for your annual physical?

Have you and your provider discussed ways for you to maintain/improve your health, such as eating healthy, ways to stay active, or taking medications?

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* 25. Have you and your provider discussed ways for you to maintain/improve your health, such as eating healthy, ways to stay active, or taking medications?

Did you (or will you) get a flu vaccination this season?

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* 26. Did you (or will you) get a flu vaccination this season?

(age 65+) Have you ever had a pneumonia vaccination?

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* 27. (age 65+) Have you ever had a pneumonia vaccination?

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