Patient Satisfaction Survey 2021

This Survey is to review the care our office gave you during 2021.

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* 1. What is your age

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* 2. Making Appointments

  Within a Few Hours Same Day The Next Day Within 3 Days 4-7 Days More than 7 Days I didn't call for this appointment
When you phoned the office to get an appointment for care you needed right away (a sick visit), how long did it take us to get you in for an appointment?
When you phoned the office to get an appointment for a follow up or non-sick visit, how long did it take us to get you in for an appointment?
When you phoned the office to get an appointment for your annual physical, how long did it take us to get you in for an appointment?

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* 3. Phone Calls & Portal Messages

  Immediately Within 15 Minutes Within 30 Minutes 1-2 Hours After The Next Day Never Recieved a Response Did Not Call/Send a Message
When you phoned the office DURING normal business hours, how long did it take for you to get an answer to what you called about?
When you phoned the office AFTER normal business hours, how long did it take for you to get an answer to what you called about?
When you sent a Portal Message to the office, how long did it take for you to get an answer to your message?
When you sent a Portal Message to the office for a medication refill, how long did it take for you to get a response that your prescription was sent?

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* 4. Telehealth

  Yes No
Have you had a virtual visit with a provider?
Were you satisfied with the virtual visit?
Did you feel it was user friendly?

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* 5. Medications

  Every Time Almost Always A Few Times Once or Twice Never I did not start or stop a medication this year. I do not take any medications.
When you talked with one of our staff (Provider, Nurse, Medical Assistant, Secretary) about starting or stopping a medication, how often were the reasons you might want to take the medication discussed with you?
When you talked with one of our staff about starting or stopping a medication, how often were the reasons you might NOT want to take the medication discussed with you?
When you talked about starting or stopping a medication, how often did our staff ask what you thought was best for you?
When you talked about starting or stopping a medication, how often did our staff ask if you were willing to follow the directions given and take the medication?

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* 6. Outside Care/Specialists (Surgeons, Cardiology, Dermatology, etc.)

  Every Visit/All the Time Quite a Few Times Frequently Sometimes Not at All I did not see a Specialist this year.
How often did our office seem informed and up-to-date about the care you got from your Specialists?
How often did you receive a referral from our office to see a Specialist?
How often did you refer yourself to a Specialist without consulting our office?

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* 7. During an Appointment

  Every Time I Talked to Someone Every Time I was Seen in the Office Almost Every Time I was Seen in the Office A Few Times Once or Twice I was never asked.
How often did anyone from our staff discuss setting specific health goals?
How often did anyone from our staff ask you if there are things that make it hard for you to take care of yourself (transportation or housing issues, communication with others, access to food)?
How often did anyone from our staff review your medications, including what medicines you are taking, the doses, and the way you take them?
How often did anyone from our staff ask you if there was a time you felt sad, empty, or depressed?
How often did anyone from our staff ask if you fell or were hurt in a fall?
How often did anyone from our staff give you easy to understand, specific to you, educational information?
How often did anyone from our staff talk to you about a personal problem, family problem, alcohol or drug use, or a mental or emotional illness?
How often did you see a Provider (Dr. Clifford, Heather, Claire) within 15 minutes of your scheduled appointment time (including how long you were in the waiting room)?

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* 8. Coordination

  Every Time Almost Every Time Often A Few Times Never N/A
When our office ordered blood work, x-rays, or other tests, how often did you receive the script as you requested it (mailed, faxed, ready to pick up) without having to ask for it again?
When our office ordered blood work, x-rays, or other tests, how often did you have to ask for it to be sent again due to our error?
When our office ordered blood work, x-rays, or other tests, how often did someone in our office follow up to give you test results?
When our office ordered blood work, x-rays, or other tests, how often did you have to call us for the results because we never called you?
How often have you gotten reminder calls to have testing done after our office ordered it?
How often did you get a reminder call or email for an upcoming appointment?
How often did our staff seem to know the important information about your medical history?
When you called the office, how often did the staff member that answered give their name?
When you called the office, how often was our staff courteous and helpful?
When you were in the office, how often was our staff courteous and helpful?

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* 9. What do you like best about this office?

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* 10. What improvements can we make to better serve you?

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