How likely is it that you would recommend your provider to a friend or family member?

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* 1. How likely is it that you would recommend your provider to a friend or family member?

Not at all likely
Extremely likely
Overall, how satisfied or dissatisfied were you with your last visit to our office?

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* 2. Overall, how satisfied or dissatisfied were you with your last visit to our office?

How convenient was the appointment time you were able to get?

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* 3. How convenient was the appointment time you were able to get?

Overall, how would you rate the care you received from your provider?

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* 4. Overall, how would you rate the care you received from your provider?

How much do you trust your provider to make medical decisions that are in your best interests?

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* 5. How much do you trust your provider to make medical decisions that are in your best interests?

How well did your provider listen to your needs?

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* 6. How well did your provider listen to your needs?

How well did your provider answer your questions?

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* 7. How well did your provider answer your questions?

How well did your provider explain your treatment options?

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* 8. How well did your provider explain your treatment options?

How well did your provider explain your follow-up care?

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* 9. How well did your provider explain your follow-up care?

Is there anything we could have done to improve your last visit?

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* 10. Is there anything we could have done to improve your last visit?

T