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Main Line Therapy Solutions Satisfaction Survey
1.
On a scale of 0 to 10,
How likely is it that you would recommend MLTS to a friend or colleague?
0 for Not at all likely, 10 for Extremely likely
Not at all likely
Extremely likely
0
1
2
3
4
5
6
7
8
9
10
2.
Overall, how satisfied or dissatisfied are you with scheduling your appointments?
Very satisfied
Somewhat satisfied
Neither satisfied nor dissatisfied
Somewhat dissatisfied
Very dissatisfied
3.
How would you rate the quality of the services you have received?
Very high quality
High quality
Neither high nor low quality
Low quality
Very low quality
4.
How responsive have we been to any questions or concerns you've had about our practice or services?
Extremely responsive
Very responsive
Somewhat responsive
Not so responsive
Not at all responsive
Not applicable
5.
How long have you and/or a family member been a client of MLTS?
This is my first appointment
Less than one month
Less than 3 months
3-6 months
Over 6 months
Over a year
Over 3 years
6.
What is the name of your clinician?
7.
Which of the following words would you use to describe your experience working with your clinician?
Reliable
Knowledgeable
Helpful and/or supportive
Friendly
Ineffective
Responsive
Lacked warmth
Professional
Effective
Unreliable
8.
How many stars would you give your clinician with 5 being the best?
1 star
2 stars
3 stars
4 stars
5 stars
9.
How many stars would you give our office environment with 5 being the best?
1 star
2 stars
3 stars
4 stars
5 stars
10.
Do you have any comments, questions, or concerns you'd like to share with us?
11.
Would you like one of our Directors to contact you regarding any of your responses?
Yes
No
If yes, how should we contact you?
Current Progress,
0 of 11 answered
