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* 1. During your most recent visit, which provider(s) did you see for your care?

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

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

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* 4. During your most recent visit, did your healthcare provider give you easy to understand information about these health questions or concerns?

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* 5. During your most recent visit, did your healthcare provider seem to know the important information about your medical history?

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* 6. Overall, how would you rate the service you received from the staff at our office?

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

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* 8. In the last 12 months, when you phoned Shenandoah Medical Center’s office after regular office hours, how often did you get an answer to your medical question as soon as you needed?

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* 9. During your most recent visit, did you see your healthcare provider within 15 minutes of your appointment time?

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* 10. During your most recent visit, how would you rate the helpfulness of the schedulers  at Shenandoah Medical Center?

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* 11. During your most recent visit, were clerks and receptionists at Shenandoah Medical Center’s office as helpful as you thought they should be?

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* 12. During your most recent visit, were you greeted upon entering the lobby?

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* 13. How easy or difficult was it to schedule your appointment at a time that was convenient for you?

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

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* 15. How satisfied or dissatisfied were you with the amount of time your provider spent with you addressing your needs?

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* 16. Using any number from 0 to 10, where 0 is the worst provider possible and 10 is the best provider possible, what number would you use to rate your healthcare provider?

  0 Worst provider possible 1 2 3 4 5 6 7 8 9 10 Best provider possible
.

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

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

NOT AT ALL LIKELY
EXTREMELY LIKELY

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* 19. Thank you for taking time to complete this survey. In order to be entered into the monthly drawing, please provide your contact information.

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