Patients Satisfaction Survey

Question Title

* 1. Check your respond below,

Walk in

Appointment

Question Title

* 2. Who was your provider today?

Gregory Walter, NP

Christy Fassbender, NP

Thomas Peterson, NP

Other (please specify)

Question Title

* 3. How likely is it that you would recommend IFHS to a friend or colleague?

NOT AT ALL LIKELY

EXTREMELY LIKELY

Question Title

* 4. Overall, how satisfied or dissatisfied are you with your visit at IFHS?

Very satisfied

Somewhat satisfied

Neither satisfied nor dissatisfied

Somewhat dissatisfied

Very dissatisfied

Question Title

* 5. Which of the following statements would you use to describe your visit at IFHS today? Select all that apply.

Reliable

Front Desk - courteous and respectful

Provider / clinician - explained procedures well

Provider / clinician - provide follow-up plan

Provider / clinician - sensitive to my needs and concerns

Staff were not sensitive to my needs

Provider / clinician did not provide attentive care and were not helpful

Facility is not clean

Poor quality care

Unreliable

Other (please specify)

Question Title

* 6. How long was your wait time at the lobby?

Within 5 minutes after check-in

Within 15 minutes after check-in

Within 30 minutes after check-in

More than 30 minutes after check-in

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* 7. How long was your wait time in the exam room before you were seen by the provider?

Within 15 minutes of entering the room

Within 30 minutes waiting in the room

1 hour or more

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* 8. How well do we meet your needs?

Extremely well

Very well

Somewhat well

Not so well

Not at all well

Question Title

* 9. How long have you been a patient at IFHS?

This is my first visit

Less than six months

Six months to a year

1 - 2 years

3 or more years

Question Title

* 10. How likely are you to return to IFHS for treatment?

Extremely likely

Very likely

Somewhat likely

Not so likely

Not at all likely

Patients Satisfaction Survey

Question Title

* 1. Check your respond below,

Question Title

* 2. Who was your provider today?

Question Title

* 3. How likely is it that you would recommend IFHS to a friend or colleague?

Question Title

* 4. Overall, how satisfied or dissatisfied are you with your visit at IFHS?

Question Title

* 5. Which of the following statements would you use to describe your visit at IFHS today? Select all that apply.

Question Title

* 6. How long was your wait time at the lobby?

Question Title

* 7. How long was your wait time in the exam room before you were seen by the provider?

Question Title

* 8. How well do we meet your needs?

Question Title

* 9. How long have you been a patient at IFHS?

Question Title

* 10. How likely are you to return to IFHS for treatment?

Question Title

* 11. Do you have any other comments, questions, or concerns?