Patient Satisfaction Survey - Rate Your Visit
Please rate your most recent visit to The Family Health Centers.
*
1.
Ease of scheduling your appointment
(Required.)
Excellent
Good
Average
Below Average
Poor
N/A
*
2.
Cleanliness and appearance of our facility
(Required.)
Excellent
Good
Average
Below Average
Poor
N/A
*
3.
Wait time for the provider
(Required.)
Excellent
Good
Average
Below Average
Poor
N/A
*
4.
Respect and courtesy shown by the front desk staff
(Required.)
Excellent
Good
Average
Below Average
Poor
N/A
*
5.
Respect and courtesy shown by our nursing staff
(Required.)
Excellent
Good
Average
Below Average
Poor
N/A
*
6.
Overall care you received from your Provider
(Required.)
Excellent
Good
Average
Below Average
Poor
N/A
*
7.
Overall care you received during Lab Work, X-Rays or Bone Density Screenings
(Required.)
Excellent
Good
Average
Below Average
Poor
N/A
*
8.
Clarity of treatment plan and/or follow-up instructions
(Required.)
Excellent
Good
Average
Below Average
Poor
N/A
*
9.
Ease of access to members of our Patient Care Team before and after your appointment
(Required.)
Excellent
Good
Average
Below Average
Poor
N/A
*
10.
Overall experience of appointment.
(Required.)
Very positive.
Somewhat positive.
Neither negative nor positive.
Somewhat negative.
Very negative.
*
11.
Likelihood of returning to The Family Health Centers for future care
(Required.)
Very likely
Somewhat likely
Not sure
Somewhat unlikely
Very unlikely
N/A
*
12.
Likelihood of recommending The Family Health Centers to family or friends
(Required.)
Very likely
Somewhat likely
Not sure
Somewhat unlikely
Very unlikely
N/A
Current Progress,
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