Our Service to You Survey

Question Title

1. Is this your first visit to a MANA Clinic?

Yes, first visit to a MANA provider/ clinic.

No, but it is my first visit to this physician or provider.

No, I am an existing patient at this clinic.

Question Title

2. Please select the clinic or department you visited.

MANA Family Medicine - North Fayetteville

MANA Family Medicine- South Fayetteville

MANA Family Medicine - HarBer

MANA Family Medicine - Prairie Grove

MANA Family Medicine - Springdale

MANA Family Medicine-Elkins

MANA Family Medicine-Thompson

Fayetteville Diagnostic Clinic Internal Medicine

Fayetteville Diagnostic Clinic Pulmonary & Sleep Medicine

Fayetteville Diagnostic Clinic Rheumatology

Imaging (X-ray, CT, Ultrasound)

MANA Family Medicine - Pinnacle Hills

MANA Family Medicine-Bentonville

MANA Psychiatry

MRI

Laboratory

Pulmonary Testing

MANA Urgent Care College

MANA Urgent Care Wedington

Millennium Chiropractic and Rehab

NWA Pediatrics - Fayetteville Acute Care

NWA Pediatrics - Fayetteville Wellness

NWA Pediatrics - Pinnacle Hills Wellness & Acute Care

Renaissance Women's Healthcare

The Breast Center - Fayetteville

The Breast Center - Bentonville

The Breast Center-Harrison

The Breast Center - Springdale

The Breast Center - Bella Vista

Question Title

3. What physician or provider did you see?

Question Title

4. What influenced your decision to choose a MANA provider? Please check all that apply.

Recommended by a friend or family member

Insurance plan

My primary physician

Web search and/or MANA Website

An online article or blog post

An ad or article in a local magazine

The location is convenient

My employer

MANA Facebook or Twitter

Phone directory

A postcard or letter in the mail

An event MANA sponsored

Other (please specify)

Question Title

5. Scheduling Your Appointment

	Good	Fair	Poor	N/A
Was myMANA a helpful tool in scheduling your appointment?	Was myMANA a helpful tool in scheduling your appointment? Good	Was myMANA a helpful tool in scheduling your appointment? Fair	Was myMANA a helpful tool in scheduling your appointment? Poor	Was myMANA a helpful tool in scheduling your appointment? N/A
Were you able to schedule your appointment by phone with ease?	Were you able to schedule your appointment by phone with ease? Good	Were you able to schedule your appointment by phone with ease? Fair	Were you able to schedule your appointment by phone with ease? Poor	Were you able to schedule your appointment by phone with ease? N/A
Was the staff friendly and professional?	Was the staff friendly and professional? Good	Was the staff friendly and professional? Fair	Was the staff friendly and professional? Poor	Was the staff friendly and professional? N/A
Did you receive an appointment in a reasonable time period?	Did you receive an appointment in a reasonable time period? Good	Did you receive an appointment in a reasonable time period? Fair	Did you receive an appointment in a reasonable time period? Poor	Did you receive an appointment in a reasonable time period? N/A

If you answered poor above, please explain. Please add any additional information you would like to share regarding scheduling your appointment.