September 2025 Patient Satisfaction Survey
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We would like to know how you feel about the services and care you receive at Grace Medical Home. This information will be used to improve our services. This survey is optional, and your answers will be kept confidential.
1.
Please indicate how well you think we are doing in the following areas?
Poor/ Strongly Disagree
Fair/ Disagree
Okay/ Neutral
Good/ Agree
Great/ Strongly Agree
N/A
My health has improved because of the care I receive here.
Poor/ Strongly Disagree
Fair/ Disagree
Okay/ Neutral
Good/ Agree
Great/ Strongly Agree
N/A
My overall experience at Grace encourages my faith in God.
Poor/ Strongly Disagree
Fair/ Disagree
Okay/ Neutral
Good/ Agree
Great/ Strongly Agree
N/A
Before becoming a patient at Grace, how would you rate your overall health?
Poor/ Strongly Disagree
Fair/ Disagree
Okay/ Neutral
Good/ Agree
Great/ Strongly Agree
N/A
After becoming a patient, how would you rate your overall health?
Poor/ Strongly Disagree
Fair/ Disagree
Okay/ Neutral
Good/ Agree
Great/ Strongly Agree
N/A
My preferred language was used during my appointment.
Poor/ Strongly Disagree
Fair/ Disagree
Okay/ Neutral
Good/ Agree
Great/ Strongly Agree
N/A
The staff and volunteers were sensitive to my cultural and ethnic background.
Poor/ Strongly Disagree
Fair/ Disagree
Okay/ Neutral
Good/ Agree
Great/ Strongly Agree
N/A
2.
If Grace Medical Home was not an option, where would you most likely go for healthcare? (check one box)
Health Clinic (like TrueHealth, Community Health Centers, Orange Blossom Family Health, etc.)
Doctor’s Office
Urgent Care Clinic (Centra Care or Minute Clinic)
Emergency Room
Would not get care
If emergency room, which one?
3.
If Grace Medical Home was not an option, where would you most likely get your medications?
Buy at Publix, Walmart, Target.
Buy at a drug store like CVS, Walgreens, etc.
Get through mail order service.
Try to get it from the drug manufacturer or other assistance program.
I would go without medications.
4.
If Grace Medical Home was not an option, where would you most likely go for dental care?
Dental Clinic (like TrueHealth, Community Health Centers, Orange Blossom Family Health, etc.)
Dentist’s Office
Emergency Room
Would not get care
If emergency room, which one?
5.
What are your sources for information about health care questions or topics?
Trust this source for accurate into
Consider the advice
Don’t trust this source
N/A Not applicable, I don’t see anything from this source
Newspaper or magazine articles
Television or radio
Doctors/nurses here at Grace
Other doctors/nurses (who work somewhere else)
Family & friends advice or experiences
People I follow on Instagram, Facebook, TikTok, etc
People I follow on Instagram, Facebook, TikTok, etc