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Patient Care Survey - OBCC

Please tell us about your clinic and /or surgical experience by answering the following questions.
What is your doctor's name?(Required.)
Rate how well your doctor accomplished the following:
Excellent
Very Good
Average
Poor
Failed
N/A (No contact/Does not apply)
Made me feel comfortable (i.e., Caring and friendly attitude)
.
Excellent
Very Good
Average
Poor
Failed
N/A (No contact/Does not apply)
Paid attention to me (i.e., looked at me, listened carefully)
.
Excellent
Very Good
Average
Poor
Failed
N/A (No contact/Does not apply)
Addressed my questions / concerns
.
Excellent
Very Good
Average
Poor
Failed
N/A (No contact/Does not apply)
Spent the right amount of time with me
.
Excellent
Very Good
Average
Poor
Failed
N/A (No contact/Does not apply)
Respected my dignity / privacy during the exam
.
Excellent
Very Good
Average
Poor
Failed
N/A (No contact/Does not apply)
Explained my medical condition and treatment plan
.
Excellent
Very Good
Average
Poor
Failed
N/A (No contact/Does not apply)
Made an effort to include me in decisions about my treatment
.
Excellent
Very Good
Average
Poor
Failed
N/A (No contact/Does not apply)
Provided instructions on my medications / activities
.
Excellent
Very Good
Average
Poor
Failed
N/A (No contact/Does not apply)
Was respectful / courteous to me and my family when talking with us
.
Excellent
Very Good
Average
Poor
Failed
N/A (No contact/Does not apply)
Talked in a way that was understandable to me
.
Excellent
Very Good
Average
Poor
Failed
N/A (No contact/Does not apply)
Checked to be sure that I understood everything
Would you recommend this doctor to your family and friends?
Please share any comments regarding your experience: