Thank you for allowing Women's Health Center to care for you!  How was your recent visit?

All information you provide is secure and HIPAA compliant.

* 2. What was the date of your visit?

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* 3. Were you able to get an appointment time as soon as you needed?

* 4. When you arrived for your appointment was the receptionist friendly and attentive?

* 5. Wait time includes time spent in the waiting room and exam room. During your most recent visit, was your wait time acceptable to you?

* 6. During your most recent visit, did your healthcare provider listen carefully to you?

* 7. During your most recent visit, did your health care provider show respect for what you had to say?

* 8. During your most recent visit, did your healthcare provider explain things in a way that was easy for you to understand?

* 9. During your most recent visit, did your healthcare provider spend enough time with you?

* 10. Would you recommend Women's Health Center to your family and friends?

* 11. How did you hear about Women's Health Center? Please include name of newpaper, magazine or radio station, if applicable.

* 12. Let us know any comments you have or how we may improve your patient experience. Include your name if you would like a personal reply.

* 13. Would you like to enter a monthly drawing for a $50 gift certificate at a local business?

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