Thank you for taking the time to provide FCHC feedback on your experience! Please think about your last visit to FCHC when answering the below questions.

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1. How likely is it that you would recommend Family Care Health Centers to a friend or family member?

NOT AT ALL LIKELY
EXTREMELY LIKELY

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2. How would you rate your overall experience with your last visit?

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3. Which Family Care Health Center did you visit? (Required.)

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4. Which department(s) did you see at your last visit? (Required.)

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5. How friendly was the front desk?

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6. How helpful was the front desk staff?

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7. How well did your Nurse/Medical Assistant answer your questions?

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8. How well did your Provider (Doctor/Nurse Practitioner) answer your questions?

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9. How well does your Provider (Doctor/Nurse Practitioner) listen to your needs?

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10. How did you feel about the length of time you spent waiting while at the clinic?

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11. How do you feel about the amount of time your Provider (Doctor/Nurse Practitioner) spends with you?

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12. How do you feel about the following statement? My Provider (Doctor/Physician Assistant/Nurse Practitioner) gives me information I can understand.

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13. Is there anything we could have done to improve your visit?

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14. We will only contact you if you have a significant complaint we need to address.

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15. We will only call you if you have a significant complaint we need to address.

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