2019 Family Health Center Patient Satisfaction Survey Your feedback is important to us! Question Title * 1. Who is your Primary Care Provider (PCP)? Scott Dunn, MD Zach Halversen, MD Jane Hoover, FNP Dan Meulenberg, MD Hannah Raynor, MD Jeremy Waters, MD Kara Waters, DO Question Title * 2. What type of insurance do you have? Commercial insurance (eg. Blue Cross, Regence Blue Shield, Pacific Source, etc.) Medicaid Medicare and/or Medicare Supplement None Other Question Title * 3. Do you know what to do if you need care outside of our regular office hours? Yes No Question Title * 4. Do you feel our hours of operation are convenient? Yes, definitely Yes, somewhat No, definitely not Other (please specify) Question Title * 5. How would you estimate the amount of time you waited during your visit? Excellent Very good Good Fair Poor Other (please specify) Question Title * 6. Did the office staff keep you informed if your appointment was going to be delayed? Yes No My appointment was not delayed Other (please specify) Question Title * 7. When you made this appointment, were you able to get an appointment on the day you asked for? Yes, I was seen on the day of my choice No, I wanted a different day No, I was not offered a choice The day did not matter to me Question Title * 8. Did you see the doctor that you wanted to see today? Yes No It did not matter who I saw today Question Title * 9. Are your prescription refill requests completed in a timely manner? Yes, definitely Yes, somewhat No, definitely not Not applicable Other (please specify) Question Title * 10. At your most recent office visit, how were you treated by the administration staff? Excellent Very Good Good Fair Poor Other (please specify) Question Title * 11. At your most recent visit, how were you treated by the nursing staff? Excellent Very Good Good Fair Poor Other (please specify) Question Title * 12. If you had an appointment with a physician or a nurse practitioner, did you feel they spent enough time with you? Yes, definitely Yes, somewhat No, definitely not Not applicable Other (please specify) Question Title * 13. If you had an appointment with a physician or a nurse practitioner, did they explain things in a way that was easy to understand? Yes, definitely Yes, somewhat No, definitely not Not applicable Other (please specify) Question Title * 14. If you had an appointment with a physician or a nurse practitioner, did you feel that they listened and respected you as a partner in your care? Yes, definitely Yes, somewhat No, definitely not Not applicable Other (please specify) Question Title * 15. In the last 12 months, when your healthcare provider ordered a blood test, x-ray, or other test for you, how often did someone from our office follow up to give you those results? Always Usually Sometimes Never NA Other (please specify) Question Title * 16. If you had an appointment with a physician or a nurse practitioner, did they talk with you about specific goals for your health? Yes, definitely Yes, somewhat No, definitely not Not applicable Other (please specify) Question Title * 17. When you are referred to another physician or specialist, do you feel informed about the next step? Yes, definitely Yes, somewhat No, definitely not Not applicable Other (please specify) Question Title * 18. During your most recent visit, did your healthcare provider seem to know the important information about your medical history? Yes, definitely Yes, somewhat No Other (please specify) Question Title * 19. Would you be interested in participating in our focus group? Yes No Question Title * 20. Is there anything else you would like to tell us? Yes No Other (please specify) Done