Patient Satisfaction Survey - redlandsfamilypractice.com

Thank you for being a patient of Redlands Family Practice.

Please take a moment to let us know how we are doing by checking the answer that best matches your experience, any additional comments and click at the bottom of the page to submit your responses. Your responses will help us improve the care your receive here at Redlands Family Practice. Please be assured this information is kept strictly confidential and we are only asking questions to measure your satisfaction with the services provided.

Please rate your experiences on a scale of 5 - 1:

Question Title

1. Please select your primary care doctor from the following list:

	Henry M. Chai, MD	Alexander Terrazas, MD	Maria Elena Terrazas, PA-C
Please select	Please select Henry M. Chai, MD	Please select Alexander Terrazas, MD	Please select Maria Elena Terrazas, PA-C

Question Title

2. Was your telephone call answered promptly and professionally?

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

Question Title

3. The amount of time it took to obtain the appointment with your primary care doctor:

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

Question Title

4. The convenience of parking and access to the office building:

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

Question Title

5. Was the reception staff friendly and courteous?

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

Question Title

6. The waiting time in the reception area:

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

Question Title

7. The appearance and cleanliness of the office:

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

Question Title

8. Was the Nursing staff friendly and knowledgeable?

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

Question Title

9. Did the doctor listen carefully to your concerns?

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

Question Title

10. Was the doctor's explanation of your medical problems and treatment plan clear and understandable?

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

Question Title

11. Did you receive the results of your test in a timely manner?

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

Question Title

12. Overall Quality of medical care:

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

Question Title

13. Comments or suggestions (optional):
Your feedback will help us to continually ensure that we meet our patients' needs. Please do not submit personal medical information to your provider through this survey.

Question Title

1. Please select your primary care doctor from the following list:

Question Title

2. Was your telephone call answered promptly and professionally?

Question Title

3. The amount of time it took to obtain the appointment with your primary care doctor:

Question Title

4. The convenience of parking and access to the office building:

Question Title

5. Was the reception staff friendly and courteous?

Question Title

6. The waiting time in the reception area:

Question Title

7. The appearance and cleanliness of the office:

Question Title

8. Was the Nursing staff friendly and knowledgeable?

Question Title

9. Did the doctor listen carefully to your concerns?

Question Title

10. Was the doctor's explanation of your medical problems and treatment plan clear and understandable?

Question Title

11. Did you receive the results of your test in a timely manner?

Question Title

12. Overall Quality of medical care:

Question Title

13. Comments or suggestions (optional):Your feedback will help us to continually ensure that we meet our patients' needs. Please do not submit personal medical information to your provider through this survey.

13. Comments or suggestions (optional):
Your feedback will help us to continually ensure that we meet our patients' needs. Please do not submit personal medical information to your provider through this survey.