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* 1. The staff are courteous and helpful when I call or visit.

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* 2. It is easy to get an appointment when I call or walk in.

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* 3. My calls to Clark Family Medicine are returned in a timely manner.

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* 4. Dr. Clark listens to me and answers my questions.

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* 5. Dr. Clark spends time with me making sure I understand my problems and treatment.

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* 6. I am informed of my test results in a timely manner.

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* 7. My after-hours calls are returned in a timely manner.

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* 8. If I am referred to a specialist, I am informed of my referral appointment in a timely manner.

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* 9. How would you rate your overall satisfaction with Clark Family Medicine?

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* 10. Additional comments:

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