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. 

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

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

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

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

* 5. Waiting time in the reception room

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

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

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

* 9. The friendliness and courtesy of the receptionist

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

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

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

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

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

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

* 16. Your ability to obtain prescription refills by phone

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

* 18. Taking time to answer your questions

* 19. Explaining things in a way you could understand

* 20. Instructions regarding medication/follow-up care

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

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

* 23. Overall Comfort

* 24. Adequate parking

* 25. Signage and directions easy to follow

* 26. Your Overall Satisfaction With:  Our Practice

* 27. The quality of your medical care

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

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

* 30. Would you recommend the provider to others?

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

* 32. Today's Date:

Date / Time

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