Town and Country Pediatrics and Family Medicine, PCPatient Experience Survey

The office is very interested in your feedback on your experience over the past six months in receiving care here. We value your feedback and we will use it to improve the care that we provide. We will not know who completed the surveys, so please be as honest and specific as you can. We appreciate your time.

	Very Satisfied	Somewhat Satisfied	Neither satisfied nor dissatisfied	Somewhat Dissatisfied	Very Dissatisfied
Ability to see a doctor when needed	Ability to see a doctor when needed Very Satisfied	Ability to see a doctor when needed Somewhat Satisfied	Ability to see a doctor when needed Neither satisfied nor dissatisfied	Ability to see a doctor when needed Somewhat Dissatisfied	Ability to see a doctor when needed Very Dissatisfied
Comments
Ability to reach the office by phone or receive a return call when needed	Ability to reach the office by phone or receive a return call when needed Very Satisfied	Ability to reach the office by phone or receive a return call when needed Somewhat Satisfied	Ability to reach the office by phone or receive a return call when needed Neither satisfied nor dissatisfied	Ability to reach the office by phone or receive a return call when needed Somewhat Dissatisfied	Ability to reach the office by phone or receive a return call when needed Very Dissatisfied
Comments
Office wait time	Office wait time Very Satisfied	Office wait time Somewhat Satisfied	Office wait time Neither satisfied nor dissatisfied	Office wait time Somewhat Dissatisfied	Office wait time Very Dissatisfied
Comments
Satisfaction with doctors' responses to any questions	Satisfaction with doctors' responses to any questions Very Satisfied	Satisfaction with doctors' responses to any questions Somewhat Satisfied	Satisfaction with doctors' responses to any questions Neither satisfied nor dissatisfied	Satisfaction with doctors' responses to any questions Somewhat Dissatisfied	Satisfaction with doctors' responses to any questions Very Dissatisfied
Comments
Quality of instructions and information offered to you by doctors about medical care	Quality of instructions and information offered to you by doctors about medical care Very Satisfied	Quality of instructions and information offered to you by doctors about medical care Somewhat Satisfied	Quality of instructions and information offered to you by doctors about medical care Neither satisfied nor dissatisfied	Quality of instructions and information offered to you by doctors about medical care Somewhat Dissatisfied	Quality of instructions and information offered to you by doctors about medical care Very Dissatisfied
Comments
Confidence in self-care	Confidence in self-care Very Satisfied	Confidence in self-care Somewhat Satisfied	Confidence in self-care Neither satisfied nor dissatisfied	Confidence in self-care Somewhat Dissatisfied	Confidence in self-care Very Dissatisfied
Comments
Overall care received through this office	Overall care received through this office Very Satisfied	Overall care received through this office Somewhat Satisfied	Overall care received through this office Neither satisfied nor dissatisfied	Overall care received through this office Somewhat Dissatisfied	Overall care received through this office Very Dissatisfied
Comments

Very Satisfied

Somewhat Satisfied

Neither satisfied nor dissatisfied

Somewhat Dissatisfied

Very Dissatisfied

Ability to see a doctor when needed

Ability to see a doctor when needed Very Satisfied

Ability to see a doctor when needed Somewhat Satisfied

Ability to see a doctor when needed Neither satisfied nor dissatisfied

Ability to see a doctor when needed Somewhat Dissatisfied

Ability to see a doctor when needed Very Dissatisfied

Comments

Ability to reach the office by phone or receive a return call when needed

Ability to reach the office by phone or receive a return call when needed Very Satisfied

Ability to reach the office by phone or receive a return call when needed Somewhat Satisfied

Ability to reach the office by phone or receive a return call when needed Neither satisfied nor dissatisfied

Ability to reach the office by phone or receive a return call when needed Somewhat Dissatisfied

Ability to reach the office by phone or receive a return call when needed Very Dissatisfied

Comments

Office wait time

Office wait time Very Satisfied

Office wait time Somewhat Satisfied

Office wait time Neither satisfied nor dissatisfied

Office wait time Somewhat Dissatisfied

Office wait time Very Dissatisfied

Comments

Satisfaction with doctors' responses to any questions

Satisfaction with doctors' responses to any questions Very Satisfied

Satisfaction with doctors' responses to any questions Somewhat Satisfied

Satisfaction with doctors' responses to any questions Neither satisfied nor dissatisfied

Satisfaction with doctors' responses to any questions Somewhat Dissatisfied

Satisfaction with doctors' responses to any questions Very Dissatisfied

Comments

Quality of instructions and information offered to you by doctors about medical care

Quality of instructions and information offered to you by doctors about medical care Very Satisfied

Quality of instructions and information offered to you by doctors about medical care Somewhat Satisfied

Quality of instructions and information offered to you by doctors about medical care Neither satisfied nor dissatisfied

Quality of instructions and information offered to you by doctors about medical care Somewhat Dissatisfied

Quality of instructions and information offered to you by doctors about medical care Very Dissatisfied

Comments

Confidence in self-care

Confidence in self-care Very Satisfied

Confidence in self-care Somewhat Satisfied

Confidence in self-care Neither satisfied nor dissatisfied

Confidence in self-care Somewhat Dissatisfied

Confidence in self-care Very Dissatisfied

Comments

Overall care received through this office

Overall care received through this office Very Satisfied

Overall care received through this office Somewhat Satisfied

Overall care received through this office Neither satisfied nor dissatisfied

Overall care received through this office Somewhat Dissatisfied

Overall care received through this office Very Dissatisfied

Comments

Town and Country Pediatrics and Family Medicine, PC
Patient Experience Survey

Question Title

* 1. Please evaluate the following statements: