1. Default Section

This survey is designed to assess your experience of patient care with Dr. Hayden. Your feedback is greatly appreciated and will help us improve our services.

* 1. What was the date of service?

Please enter the date of service.
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* 2. Patient's name.

* 3. Please rate your overall experience with Dr. Hayden.

* 4. You will be asked to rate Dr. Hayden's competence in 6 areas, based upon the service provided on the date you indicated above.
The first area is competence in patient care. How would you rate Dr. Hayden's competence in patient care?

* 5. How would you rate Dr. Hayden's knowledge of psychiatry?

* 6. How would you rate Dr. Hayden's knowledge of the psychiatric treatment resources in the community in which he practices?

* 7. How would you rate Dr. Hayden's professionalism?

* 8. How would you rate Dr. Hayden's ability to look up information he does not know in the course of patient care?

* 9. How would you rate Dr. Hayden's interpersonal and communication skills?

* 10. Please add your comments here (500 characters allowed):

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