Health Center Patient Satisfaction Survey Thank you for choosing the Margaret Mary Health Center for your health care needs. By sharing your impressions of your recent visit, you can help our team improve the quality of care and service you receive. Question Title * 1. Are you a new patient or an established patient? New Established Question Title * 2. Date of Your Visit: Question Title * 3. Name of Your Provider: On a scale of 1 to 5, with '1' being 'Strongly Disagree' and '5' being 'Strongly Agree,' please rate your care. Question Title * 4. The location of the clinic is easy to find. 1: Strongly Disagree 2: Disagree 3: Neutral 4: Agree 5: Strongly Agree Comments Question Title * 5. My provider is available when I need care. 1: Strongly Disagree 2: Disagree 3: Neutral 4: Agree 5: Strongly Agree Comments Question Title * 6. My provider listened and answered my questions. 1: Strongly Disagree 2: Disagree 3: Neutral 4: Agree 5: Strongly Agree Comments Question Title * 7. I trust my provider with my medical care. 1: Strongly Disagree 2: Disagree 3: Neutral 4: Agree 5: Strongly Agree Comments Question Title * 8. I feel confident managing my care at home. 1: Strongly Disagree 2: Disagree 3: Neutral 4: Agree 5: Strongly Agree Comments Question Title * 9. I am notified of any test results, medication changes or referrals to specialists. 1: Strongly Disagree 2. Disagree 3: Neutral 4: Agree 5: Strongly Agree Comments Question Title * 10. I do not have any concerns about my privacy while at the clinic. 1: Strongly Disagree 2: Disagree 3: Neutral 4: Agree 5: Strongly Agree Comments Question Title * 11. The cleanliness of the clinic was acceptable. 1: Strongly Disagree 2: Disagree 3: Neutral 4: Agree 5: Strongly Agree Comments Question Title * 12. There was good communication between members of the clinic team about my care. 1: Strongly Disagree 2: Disagree 3: Neutral 4: Agree 5: Strongly Agree Comments Question Title * 13. I was involved in the decision making/planning process of my care as much as I wanted to be. 1: Strongly Disagree 2: Disagree 3: Neutral 4: Agree 5: Strongly Agree Comments Question Title * 14. I will recommend this provider and clinic to my family and friends. 1: Strongly Disagree 2: Disagree 3: Neutral 4: Agree 5: Strongly Agree Comments Question Title * 15. The nominal fee is reasonable. 1: Strongly Disagree 2: Disagree 3: Neutral 4: Agree 5: Strongly Agree Comments Question Title * 16. Patient financial staff are helpful and knowledgeable to help me pay my bill. 1. Strongly Disagree 2: Disagree 3: Neutral 4: Agree 5: Strongly Agree Comments Question Title * 17. My overall satisfaction with my care was high. 1: Strongly Disagree 2: Disagree 3: Neutral 4: Agree 5: Strongly Agree Comments b'Thank you for completing our survey. We value your input to improve our services. ' Page1 / 1 100% of survey complete. Done