Patient Satisfaction Survey
1.
On a scale of 0 to 10,
How likely is it that you would recommend your doctor to a friend or family member?
0 for Not at all likely, 10 for Extremely likely
Not at all likely
Extremely likely
0
1
2
3
4
5
6
7
8
9
10
2.
Overall, how would you rate the service you received from the staff at the clinics of Drs. Smoker ?
Excellent
Very good
Good
Fair
Poor
3.
How easy or difficult was it to schedule your appointment at a time that was convenient for you?
Very easy
Easy
Neither easy nor difficult
Difficult
Very difficult
4.
How easy is it to schedule urgent appointments with your doctor when you're ill?
Extremely easy
Very easy
Somewhat easy
Not so easy
Not at all easy
5.
How comfortable was the lobby and waiting area?
Extremely comfortable
Very comfortable
Somewhat comfortable
Not so comfortable
Not at all comfortable
6.
How friendly is your doctor's office staff?
Extremely friendly
Very friendly
Somewhat friendly
Not so friendly
Not at all friendly
7.
Did your appointment with your provider start early, late or on time?
Very early
Early
On time
Late
Very late
8.
Overall, how would you rate the service you received from the staff at our office?
Excellent
Very good
Good
Fair
Poor
9.
During your most recent visit, did your healthcare provider listen carefully to you?
Yes, definitely
Yes, somewhat
No
10.
How well did your provider answer your questions?
Extremely well
Very well
Somewhat well
Not so well
Not at all well
11.
How satisfied or dissatisfied were you with the amount of time your provider spent with you addressing your needs?
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
12.
Overall, how would you rate the care you received from your provider?
Excellent
Very good
Good
Fair
Poor
13.
At which of our clinics do you normally receive your care?
14.
Who is your primary care provider?
15.
Please share any other comments you have below:
Current Progress,
0 of 15 answered