Medical Patient Survey

 100% 
1. Please respond to how you agree with the following statements regarding EASE OF GETTING CARE:
Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeN/A
Ability to get in and be seen was easy
Office hours are convenient
Office location is convenient
Return calls are prompt
2. Please respond to how you agree with the following statements regarding WAITING TIME:
Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeN/A
Time in waiting room was acceptable
Time in exam room was acceptable
3. Please respond to how you agree with the following statements regarding PHYSICIANS AND STAFF:
Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeN/A
Administrative staff (front desk, phone staff) are friendly and helpful
Administrative staff (front desk, phone staff) to my concerns and answers questions
Physicians listen to you
Physicians take enough time to understand your concerns
Physicians explain what you want to know
Physicians give you good advice and treatment
Physicians are friendly and helpful
4. Please respond to how you agree with the following statements regarding THE FACILITY:
Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeN/A
Building and office is clean and neat
Waiting area safe and comfortable
Easy to find where to go
I feel my privacy is protected
5. Please respond to how you agree with the following statements regarding CONFIDENTIALITY:
Strongly DisagreeDisagreeNeutralAgreeStrongly AgreeN/A
I feel confident that my information will be kept private
I am likely to refer friends and family to Central Virginia OBGYN
6. Please use the space below to add any comments you may have.
Powered by SurveyMonkey
Check out our sample surveys and create your own now!