SurveyMonkey Powered Online Survey

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.

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

Great

Good

Fair

Poor

Ability to get in to be seen:

Ability to get in to be seen: Great

Ability to get in to be seen: Good

Ability to get in to be seen: OK

Ability to get in to be seen: Fair

Ability to get in to be seen: Poor

Hours office is open:

Hours office is open: Great

Hours office is open: Good

Hours office is open: OK

Hours office is open: Fair

Hours office is open: Poor

Convenience of office's location:

Convenience of office's location: Great

Convenience of office's location: Good

Convenience of office's location: OK

Convenience of office's location: Fair

Convenience of office's location: Poor

Prompt return on calls:

Prompt return on calls: Great

Prompt return on calls: Good

Prompt return on calls: OK

Prompt return on calls: Fair

Prompt return on calls: Poor

Time in waiting room:

Time in waiting room: Great

Time in waiting room: Good

Time in waiting room: OK

Time in waiting room: Fair

Time in waiting room: Poor

Time in exam room:

Time in exam room: Great

Time in exam room: Good

Time in exam room: OK

Time in exam room: Fair

Time in exam room: Poor

Waiting for tests to be performed:

Waiting for tests to be performed: Great

Waiting for tests to be performed: Good

Waiting for tests to be performed: OK

Waiting for tests to be performed: Fair

Waiting for tests to be performed: Poor

Waiting for test results:

Waiting for test results: Great

Waiting for test results: Good

Waiting for test results: OK

Waiting for test results: Fair

Waiting for test results: Poor

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

Great

Good

Fair

Poor

Listens to you:

Listens to you: Great

Listens to you: Good

Listens to you: OK

Listens to you: Fair

Listens to you: Poor

Takes enough time with you:

Takes enough time with you: Great

Takes enough time with you: Good

Takes enough time with you: OK

Takes enough time with you: Fair

Takes enough time with you: Poor

Explains what you want to know:

Explains what you want to know: Great

Explains what you want to know: Good

Explains what you want to know: OK

Explains what you want to know: Fair

Explains what you want to know: Poor

Gives you good advice and treatment:

Gives you good advice and treatment: Great

Gives you good advice and treatment: Good

Gives you good advice and treatment: OK

Gives you good advice and treatment: Fair

Gives you good advice and treatment: Poor

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

Great

Good

Fair

Poor

Friendly and helpful to you:

Friendly and helpful to you: Great

Friendly and helpful to you: Good

Friendly and helpful to you: OK

Friendly and helpful to you: Fair

Friendly and helpful to you: Poor

Answers your questions:

Answers your questions: Great

Answers your questions: Good

Answers your questions: OK

Answers your questions: Fair

Answers your questions: Poor

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

Great

Good

Fair

Poor

Friendly and helpful to you:

Friendly and helpful to you: Great

Friendly and helpful to you: Good

Friendly and helpful to you: OK

Friendly and helpful to you: Fair

Friendly and helpful to you: Poor

Answers your questions:

Answers your questions: Great

Answers your questions: Good

Answers your questions: OK

Answers your questions: Fair

Answers your questions: Poor

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

Great

Good

Fair

Poor

What you pay:

What you pay: Great

What you pay: Good

What you pay: OK

What you pay: Fair

What you pay: Poor

Explanation of charges:

Explanation of charges: Great

Explanation of charges: Good

Explanation of charges: OK

Explanation of charges: Fair

Explanation of charges: Poor

Collection of payment/money:

Collection of payment/money: Great

Collection of payment/money: Good

Collection of payment/money: OK

Collection of payment/money: Fair

Collection of payment/money: Poor

Neat and clean building:

Neat and clean building: Great

Neat and clean building: Good

Neat and clean building: OK

Neat and clean building: Fair

Neat and clean building: Poor

Ease of finding where to go:

Ease of finding where to go: Great

Ease of finding where to go: Good

Ease of finding where to go: OK

Ease of finding where to go: Fair

Ease of finding where to go: Poor

Comfort and Safety while waiting:

Comfort and Safety while waiting: Great

Comfort and Safety while waiting: Good

Comfort and Safety while waiting: OK

Comfort and Safety while waiting: Fair

Comfort and Safety while waiting: Poor

Keeping my personal information private: The likelihood of referring your friends and relatives to us:

Keeping my personal information private: The likelihood of referring your friends and relatives to us: Great

Keeping my personal information private: The likelihood of referring your friends and relatives to us: Good

Keeping my personal information private: The likelihood of referring your friends and relatives to us: OK

Keeping my personal information private: The likelihood of referring your friends and relatives to us: Fair

Keeping my personal information private: The likelihood of referring your friends and relatives to us: Poor

1. Service Characteristics

Question Title

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

Question Title

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

Question Title

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

Question Title

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

Question Title

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

Question Title

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

Question Title

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

Question Title

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

Question Title

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

Question Title

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

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

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

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

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