UBMD Orthopaedics & Sports Medicine Patient Satisfaction Survey As a patient of ours, your opinion is very important to us. Our team’s goal is to provide an exceptional experience for each patient. Your input will help us to continuously improve the quality of our patients’ health care. Question Title * 1. Physician Name Robert Ablove, MD Mark Anders, MD David Bagnall, MD Geoffrey Bernas, MD Leslie Bisson, MD Craig Blum, MD Lindsey Clark, MD James Czyrny, MD Scott Darling, MD Matthew DiPaola, MD Jeremy Doak, MD Thomas Duquin, MD Evgeny Dyskin, MD Michael Ferrick, MD Marc Fineberg, MD Michael Freitas, MD Robert Galpin, MD Jennifer Gurske-dePerio, MD Christopher Hamill, MD Rajiv Jain, MD Joshua Jones, MD Joseph Kowalski, MD Joseph Kuechle, MD John Leddy, MD Kevin Lesh, MD John Marzo, MD Brian McGrath, MD Christopher Mutty, MD Matthew Phillips, MD Sridhar Rachala, MD Michael Rauh, MD Christopher Ritter, MD Bernhard Rohrbacher, MD Mario Santilli, MD Philip Stegemann, MD Robert Smolinski, MD Heidi Suffoletto, MD William Wind, Jr., MD Other or PA/PT/Nurse (please specify) Question Title * 2. Location Amherst Health Center - 4949 Harlem Road, Amherst ECMC - 462 Grider Street, Buffalo BrookBridge - 5959 Big Tree Road, Orchard Park Summit Healthplex - 6934 Williams Road, Niagara Falls UB South Campus - 160 Farber Hall, Buffalo Conventus - 1001 Main Street, Buffalo 4180 Abbott Road, Orchard Park 3673 Southwestern Blvd., Orchard Park Other (please specify) Question Title * 3. How long have you been seeing this healthcare provider? This was my first appointment Less than 6 months 6-12 months 1-3 years 3-5 years 5+ years Question Title * 4. Using any number from 1-10, where 1 is the worst provider possible and 10 is the best provider possible, what number would you use to rate your healthcare provider? 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 Question Title * 5. During your most recent visit, did your healthcare provider give you easy to understand information about your questions or concerns? Yes, Definitely Yes, Somewhat No Question Title * 6. Would you recommend your healthcare provider's office to your friends and family? Yes, Definitely Yes, Somewhat No Question Title * 7. Please rate your experiences with the following. 0=Very Poor and 10=Excellent. Select “N/A” if not applicable. 0 1 2 3 4 5 6 7 8 9 10 N/A Telephone Answering Service Telephone Answering Service 0 Telephone Answering Service 1 Telephone Answering Service 2 Telephone Answering Service 3 Telephone Answering Service 4 Telephone Answering Service 5 Telephone Answering Service 6 Telephone Answering Service 7 Telephone Answering Service 8 Telephone Answering Service 9 Telephone Answering Service 10 Telephone Answering Service N/A Scheduling Your Appointment Scheduling Your Appointment 0 Scheduling Your Appointment 1 Scheduling Your Appointment 2 Scheduling Your Appointment 3 Scheduling Your Appointment 4 Scheduling Your Appointment 5 Scheduling Your Appointment 6 Scheduling Your Appointment 7 Scheduling Your Appointment 8 Scheduling Your Appointment 9 Scheduling Your Appointment 10 Scheduling Your Appointment N/A Front Desk Reception Area Front Desk Reception Area 0 Front Desk Reception Area 1 Front Desk Reception Area 2 Front Desk Reception Area 3 Front Desk Reception Area 4 Front Desk Reception Area 5 Front Desk Reception Area 6 Front Desk Reception Area 7 Front Desk Reception Area 8 Front Desk Reception Area 9 Front Desk Reception Area 10 Front Desk Reception Area N/A Physician's Staff Physician's Staff 0 Physician's Staff 1 Physician's Staff 2 Physician's Staff 3 Physician's Staff 4 Physician's Staff 5 Physician's Staff 6 Physician's Staff 7 Physician's Staff 8 Physician's Staff 9 Physician's Staff 10 Physician's Staff N/A Imaging Services (x-ray and/or MRI) Imaging Services (x-ray and/or MRI) 0 Imaging Services (x-ray and/or MRI) 1 Imaging Services (x-ray and/or MRI) 2 Imaging Services (x-ray and/or MRI) 3 Imaging Services (x-ray and/or MRI) 4 Imaging Services (x-ray and/or MRI) 5 Imaging Services (x-ray and/or MRI) 6 Imaging Services (x-ray and/or MRI) 7 Imaging Services (x-ray and/or MRI) 8 Imaging Services (x-ray and/or MRI) 9 Imaging Services (x-ray and/or MRI) 10 Imaging Services (x-ray and/or MRI) N/A Billing Department Billing Department 0 Billing Department 1 Billing Department 2 Billing Department 3 Billing Department 4 Billing Department 5 Billing Department 6 Billing Department 7 Billing Department 8 Billing Department 9 Billing Department 10 Billing Department N/A Question Title * 8. To leave a testimonial on our website, please leave comments here. Thank you! Question Title * 9. Where did you hear about UBMD Orthopaedics & Sports Medicine? Check all that apply. Friend/Family Primary Care Doctor/Pediatrician Searching the Internet Radio Advertisement Television Sports Sponsorship Community Event Other (please specify) Done