1. Service Characteristics

Please take a few minutes to complete this 10 question survey on the quality of service we provide. We welcome your feedback and appreciate your honesty. With your help, we hope to strengthen the bond between our clients.

* 1. EASE OF GETTING CARE AND OFFICE WAIT TIMES
Please rank the following:

  Great Good OK Fair Poor
Ability to get in to be seen:
Hours office is open:
Convenience of office's location:
Prompt return on calls:
Time in waiting room:
Time in exam room:
Waiting for tests to be performed:
Waiting for test results:

* 2. PROVIDER (MD, PA-C, NP)
Please rate the following:

  Great Good OK Fair Poor
Listens to you:
Takes enough time with you:
Explains what you want to know:
Gives you good advice and treatment:

* 3. NURSES/MEDICAL ASSISTANT (MA)
Please rate the following:

  Great Good OK Fair Poor
Friendly and helpful to you:
Answers your questions:

* 4. CHECK IN, CHECK OUT, SURGICAL BOOKING
Please rate the following:

  Great Good OK Fair Poor
Friendly and helpful to you:
Answers your questions:

* 5. PAYMENT, FACILITY, AND PRIVACY/CONFIDENTIALITY RATINGS: Please rate the following:

  Great Good OK Fair Poor
What you pay:
Explanation of charges:
Collection of payment/money:
Neat and clean building:
Ease of finding where to go:
Comfort and Safety while waiting:
Keeping my personal information private: The likelihood of referring your friends and relatives to us:

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