* 1. Who was your provider today?

* 2. Did you see the provider that you wanted to see today?

* 3. How would you rate the length of time you waited to get this appointment?

* 4. How would you rate your waiting time for today's visit?

* 5. How would you rate your experience getting through to Miramont Family Medicine by phone?

* 6. Compared to other offices, the quality of care at Miramont Family Medicine is...?

* 7. Based on your telephone contacts with Miramont Family Medicine over the past few months, how easy has it been for you to do the following?

  Very difficult Difficult Easy Very Easy
Make appointments?
Get prescriptions refilled?
Get lab results?
Talk to a nurse or medical assistant?
Talk to your physician or provider?

* 8. I would recommend Miramont Family Medicine to my family and friends.

* 9. What do we need to know to improve our customer service?

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