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* 1. Where did you receive care today?

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* 2. Did you feel you received an appointment as soon as you needed one?

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* 3. Did our staff make you feel welcome?

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* 4. Do you feel that Family HealthCare's Access Plan (Sliding Fee Scale) co-pays were reasonable?

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* 5. From when you entered the building to when your provider entered your exam room, how would you rate the amount of time spent waiting?

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* 6. Were your concerns addressed at your appointment? 

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* 7. Did your Family HealthCare provider seem informed about the care you have received from other providers?

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* 8. Did your provider include you in making decisions about your health?

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* 9. Did your provider explain things in a way that you clearly understood?

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* 10. How would you rate the kindness of the staff who interacted with you?

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* 11. How would you rate your overall experience of today's visit?

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* 12. Which of the following appointment options would you most like to see offered at Family HealthCare?

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* 13. Based upon your experience during your visit, are you likely to recommend Family HealthCare to a friend or family member?

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* 14. Is there anything you would like to tell us about your experience?

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