Associates In Women's Healthcare Patient Satisfaction Survey

Thank you for taking the time to complete this short survey.  Please be reassured that responses are anonymous unless you request follow up by submitting your contact info on the last question. 
 
We routinely analyze patient feedback and review survey comments at staff meetings.  Your concerns and criticisms are used constructively to make improvements.  Positive feedback is truly appreciated.  All of our staff and especially the physicians enjoy hearing from you. 
 
In order to maintain the integrity of this CAHPS survey which helps us maintain our NCQA Certification, we are not able to change the format so just skip any questions that are not applicable.  

                                                                                                                      Drs. Mohr, Gizzie, Moody, Jacokes and Chawla

* 1. How long have you been going to Associates In Women's Healthcare?

* 2. Which  physician did you see at your recent visit?

* 3. Using any number from 0 to 10, where 0 is the worst provider possible and 10 is the best provider possible, what number would you use to rate Associates In Women's Healthcare?

  10 Best provider possible 9 8 7 6 5 4 3 2 1 0 Worst provider possible
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* 4. In the last 12 months, when you phoned Associates In Women's Healthcare’s office to get an appointment for care you needed right away, how often did you get an appointment as soon as you needed?

* 5. In the last 12 months, when you made an appointment for a check-up or routine care with Associates In Women's Healthcare, how often did you get an appointment as soon as you needed?

* 6. In the last 12 months, when you phoned Associates In Women's Healthcare’s office during regular office hours, how often did you get an answer to your medical question that same day?

* 7. In the last 12 months, when you phoned Associates In Women's Healthcare’s office after regular office hours, how often did you get an answer to your medical question as soon as you needed?

* 8. Wait time includes time spent in the waiting room and exam room. In the last 12 months, how often did you see the intake nurse or the physician within 15 minutes of your appointment time?

* 9. In the last 12 months, how often did the physician listen carefully to you?

* 10. In the last 12 months, how often did physician explain things in a way that was easy to understand?

* 11. In the last 12 months, how often did the physician give you easy to understand information about these health questions or concerns?

* 12. In the last 12 months, how often did the physician seem to know the important information about your medical history?

* 13. In the last 12 months, how often did the physician spend enough time with you?

* 14. In the last 12 months, when your physician ordered a blood test, x-ray, or other test for you, how often did someone from this provider’s office follow up to give you those results?

* 15. In the last 12 months, how often were clerks and receptionists at Associates In Women's Healthcare's office as helpful as you thought they should be?

* 16. In the last 12 months, how often did clerks and receptionists at Associates In Women's Healthcare's office treat you with courtesy and respect?

* 17. In general, how would you rate your overall health?

* 18. What is your age?

* 19. How likely is it that you would recommend Associates In Womens Healthcare to a friend or colleague?

Not at all likely
Extremely likely

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

* 21. If you would like for us to follow up with you regarding concerns expressed in this survey, please provide your contact information.

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