Dear Patient, Thank you for choosing Premier Surgical. By filling out this brief survey, you help us provide better customer service. Upon completion, you will be entered into a drawing for a $100 VISA gift card.

How would you rate the ability to make an appointment?

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* 3. How would you rate the ability to make an appointment?

How would you rate the amount of time you spentĀ in the waiting room?

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* 4. How would you rate the amount of time you spentĀ in the waiting room?

How well did your Premier Surgical Physician explain your procedure and answer your questions?

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* 5. How well did your Premier Surgical Physician explain your procedure and answer your questions?

Overall, how would you rate the service you received from our Premier Surgical nursing and office staff?

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* 6. Overall, how would you rate the service you received from our Premier Surgical nursing and office staff?

If you had an Ultrasound exam, how would you rate the service you received from the Ultrasound staff?

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* 7. If you had an Ultrasound exam, how would you rate the service you received from the Ultrasound staff?

How would you rate the cleanliness and comfort of the Premier Surgical office you visited?

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* 8. How would you rate the cleanliness and comfort of the Premier Surgical office you visited?

If you worked with our Central Billing Office, how would you rate that service?

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* 9. If you worked with our Central Billing Office, how would you rate that service?

Overall, how would you rate your experience with the Premier Surgical office you visited?

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* 10. Overall, how would you rate your experience with the Premier Surgical office you visited?

Would you recommend Premier Surgical to your family or friends?

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* 11. Would you recommend Premier Surgical to your family or friends?

Is there anything we could have done to improve your experience with Premier Surgical?

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* 12. Is there anything we could have done to improve your experience with Premier Surgical?

If you had an unpleasant experience and would like to share your concerns with a Premier Surgical Administrator, please list your phone number so we may contact you.

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* 13. If you had an unpleasant experience and would like to share your concerns with a Premier Surgical Administrator, please list your phone number so we may contact you.

Please name a Premier Surgical physician or staff member who left a positive impression on you.

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* 14. Please name a Premier Surgical physician or staff member who left a positive impression on you.

For notification if you are selected as the $100 VISA gift card winner, please enter your email.

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* 15. For notification if you are selected as the $100 VISA gift card winner, please enter your email.

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100% of survey complete.

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