Patient Satisfaction Survey

Our goal is to provide a positive experience for you and your children as well as the best medical care to all our patients at every visit.  We are using this survey to help improve our access, scheduling and services.  Your responses are anonymous and strictly confidential.  Your responses will help us achieve our goals.  Thank you for your valuable feedback. 

Regarding Your Appointments:  Ease of making an appointments by phone

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* 1. Regarding Your Appointments:  Ease of making an appointments by phone

Was your appointment available within a reasonable amount of time

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* 2. Was your appointment available within a reasonable amount of time

Getting care for illness/injury as soon as you wanted it

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* 3. Getting care for illness/injury as soon as you wanted it

Getting after-hours care when you needed it

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* 4. Getting after-hours care when you needed it

Waiting time in the reception room

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* 5. Waiting time in the reception room

Waiting time in the exam room to see your provider

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* 6. Waiting time in the exam room to see your provider

Ease of getting a referral when you needed one

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* 7. Ease of getting a referral when you needed one

Regarding Our Staff: The courtesy of the person who took your call

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* 8. Regarding Our Staff: The courtesy of the person who took your call

The friendliness and courtesy of the receptionist

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* 9. The friendliness and courtesy of the receptionist

The caring concern of our nurses/medical assistants

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* 10. The caring concern of our nurses/medical assistants

The helpfulness of the people who assisted you with billing or insurance

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* 11. The helpfulness of the people who assisted you with billing or insurance

Our Communication with you:  Your phone calls answered promptly

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* 12. Our Communication with you:  Your phone calls answered promptly

Getting advice or help when needed during office hours

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* 13. Getting advice or help when needed during office hours

Your test results reported in a reasonable amount of time

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* 14. Your test results reported in a reasonable amount of time

Our ability to return calls in a timely manner

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* 15. Our ability to return calls in a timely manner

Your ability to obtain prescription refills by phone

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* 16. Your ability to obtain prescription refills by phone

Your Visit with the Provider:  Willingness to listen carefully to you

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* 17. Your Visit with the Provider:  Willingness to listen carefully to you

Taking time to answer your questions

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* 18. Taking time to answer your questions

Explaining things in a way you could understand

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* 19. Explaining things in a way you could understand

Instructions regarding medication/follow-up care

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* 20. Instructions regarding medication/follow-up care

Advice given to you on ways to stay healthy

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* 21. Advice given to you on ways to stay healthy

Our Facility:  Hours of operation convenient for you

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* 22. Our Facility:  Hours of operation convenient for you

Overall Comfort

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* 23. Overall Comfort

Adequate parking

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* 24. Adequate parking

Signage and directions easy to follow

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* 25. Signage and directions easy to follow

Your Overall Satisfaction With:  Our Practice

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* 26. Your Overall Satisfaction With:  Our Practice

The quality of your medical care

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* 27. The quality of your medical care

Overall rating of care from your provider or clinical staff

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* 28. Overall rating of care from your provider or clinical staff

Are our community resources appropriate for your needs?

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* 29. Are our community resources appropriate for your needs?

Would you recommend the provider to others?

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* 30. Would you recommend the provider to others?

Is there anything we could improve?  Please tell us about it.

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* 31. Is there anything we could improve?  Please tell us about it.

Today's Date:

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* 32. Today's Date:

Date / Time
If you have medical insurance, please tell us which one.

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* 34. If you have medical insurance, please tell us which one.

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