1. PATIENT SATISFACTION SURVEY

Thank you for taking the time to complete this satisfaction survey. The Fetal & Women’s Center welcome your comments and feedback to assist us in providing the highest quality prenatal diagnosis, counseling, and women’s ultrasound services available.

* 1. What was the date of your appointment?

Date
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* 2. At what office were you seen?

* 3. Which physician referred you to our office?

* 4. What kind of exam did you have?

* 5. Was this your preferred appointment date/time?

* 6. Did our front desk staff greet you in a timely and courteous manner?

* 7. Did our staff explain the paperwork and/or co-pay charges to your satisfaction?

* 8. Our goal is to stay on schedule with every patient; however, we also strive to take as much time as needed to ensure a thorough exam/evaluation. How would you rate the waiting time before your exam?

* 9. Was the Sonographer? (please check all that apply)

* 10. If you saw a Physician, was he/she? (please check all that apply)

* 11. Did the physician introduce him/herself to you?

* 12. Did the physician listen carefully to you and answer all of your questions?

* 13. If you spoke to a physician via webcam, please rate your experience.

* 14. If you saw a diabetic or genetic counselor, was he/she? (please check all that apply)

* 15. How would you rate your interaction with our billing department?

* 16. How was your overall experience at Fetal & Women's Center?

* 17. From time to time, we email information related to women's health and health related events. If you would like to be added to our mailing list, please provide us with your email address.

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