Good Samaritan Health Centers, Inc. Wildflower Clinic

Your information (this is optional)

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* 1. Your information (this is optional)

Overall, how satisfied or dissatisfied were you with your last visit to our clinic?

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* 4. Overall, how satisfied or dissatisfied were you with your last visit to our clinic?

About how long did you have to wait to be seen by the provider?

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* 5. About how long did you have to wait to be seen by the provider?

Please rate the quality of care from each person you interacted with during your last visit.

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* 6. Please rate the quality of care from each person you interacted with during your last visit.

  Excellent Very Good Good Fair Poor N/A
Front Desk/Receptionist
Doctor
Dentist
Dental Assistant
Nurse
Medical Coordinator
Dental Coordinator
Director
How well did you feel the staff listened to your needs & answered any questions you may have had?

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* 7. How well did you feel the staff listened to your needs & answered any questions you may have had?

Did you feel your treatment options & follow-up care were explained to you thoroughly?

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* 8. Did you feel your treatment options & follow-up care were explained to you thoroughly?

How likely are you to recommend our clinic to others?

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* 9. How likely are you to recommend our clinic to others?

Please give us any additional feedback about your experience.

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* 10. Please give us any additional feedback about your experience.

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