We would like to know how you feel about the services we provide so we can make sure we are meeting your needs. Your responses are directly responsible for improving these services.

All responses will be kept confidential and anonymous.

For each statement or question please check the answer that best describes your experience of care during the past twelve months.

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* 1. At which of our centers are you most frequently seen?

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* 2. When I call to get an appointment, I am able to get an appointment as soon as I need one.

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* 3. When I call the office during office hours, I get an answer to my medical questions that day.

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* 4. My provider listens to my concerns and questions.

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* 5. When I call the office during office hours I get an answer  to my pharmacy question the same day.

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* 6. When my provider orders blood tests, x-rays, or other tests, the office follows up to give me the results.

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* 7. In the last 12 months, how often did someone in the practice talk to you about specific goals for your health?

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* 8. How likely are you to recommend this office to your family and friends?

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* 9. What is your age?

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* 10. Do you have difficulty with transportation getting to your appointment(s)?

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