SMC Clinic Patient Experience Survey

Question Title

* 1. During your most recent visit, which provider(s) did you see for your care?

Dr. Babe

Dr. Bumgarner

Dr. Isaacson

Dr. Brown

Connie Holmes, ARNP

Kristen Thatcher, ARNP

Krista Wilson, ARNP

Dr. Smith

Stephanie Robinette, DNP

Dr. Rozeboom

Dr. MacLeod-Kozal

Dr. Woods

Jona Hutson, DNP, CNM

Renee Johnson, FNP

Dr. Rose

Dr. Rowan

Rose Walter

Melissa Hobbie

Jessica Heitkamp, ARNP

Mary Nissen, DNP

Dena Herzberg, ARNP

Other (please specify)

Question Title

* 2. Is this the provider you usually see if you need a check-up, want advice about a health problem, or get sick or hurt?

Yes

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* 3. How long have you been going to this provider?

Less than 6 months

At least 6 months but less than 1 year

At least 1 year but less than 3 years

At least 3 years but less than 5 years

5 years or more

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* 4. In the last 6 months, when you contacted this provider's office during regular office hours, how often did you get an answer to your medical question that same day?

Always

Usually

Sometimes

Never

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* 5. How often were you able to schedule an appointment at your preferred availability?

Always

Usually

Sometimes

Never

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* 6. In the last 6 months, how often did this provider explain things in a way that was easy to understand?

Always

Usually

Sometimes

Never

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* 7. In the last 6 months, how often did this provider show respect for what you had to say?

Always

Usually

Sometimes

Never

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* 8. In the last 6 months, how often did this provider spend enough time with you?

Always

Usually

Sometimes

Never

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* 9. 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 your healthcare provider?

	0 Worst provider possible	1	2	3	4	5	6	7	8	9	10 Best provider possible
.	. 0 Worst provider possible	. 1	. 2	. 3	. 4	. 5	. 6	. 7	. 8	. 9	. 10 Best provider possible

SMC Clinic Patient Experience Survey

Question Title

* 1. During your most recent visit, which provider(s) did you see for your care?

Question Title

* 2. Is this the provider you usually see if you need a check-up, want advice about a health problem, or get sick or hurt?

Question Title

* 3. How long have you been going to this provider?

Question Title

* 4. In the last 6 months, when you contacted this provider's office during regular office hours, how often did you get an answer to your medical question that same day?

Question Title

* 5. How often were you able to schedule an appointment at your preferred availability?

Question Title

* 6. In the last 6 months, how often did this provider explain things in a way that was easy to understand?

Question Title

* 7. In the last 6 months, how often did this provider show respect for what you had to say?

Question Title

* 8. In the last 6 months, how often did this provider spend enough time with you?

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* 9. 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 your healthcare provider?

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* 10. Did someone talk with you about what you would like to fix or improve about your health?

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* 11. Did someone ask you about what makes it hard to take care of your health?

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* 12. Is there anything we could have done to improve your most recent visit?