CNM Patient Survey

1
Who is your primary health care provider?A health care provider can care for patients in person, by phone, or by video. Our records show that you got care from one of our care providers in the last 6 months. Please select your primary health care provider.
Please Select
Please Select
Dr. Ruth Carden
Dr. Lai Chim Chan
Dr. Bob Graybill
Dr. Marissa Hanthorn
Dr. Sean Horan
Dr. Matthew Knudsen
Dr. Janna Redding
Dr. Dana Waichunas
Dr. Stacie Wolfe
Nobody on this list
The questions in this survey will refer to the provider named in Question 1 as “this provider.” As you answer these questions, please think of the in-person, phone, and video visits you had with that person in the last 6 months.
2
How likely is it that you would recommend your provider to a friend or family member?
0
1
2
3
4
5
6
7
8
9
10
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0
1
2
3
4
5
6
7
8
9
10
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3
Overall, how satisfied were you with your last visit to our office?
Not Satisfied
Somewhat Satisfied
Neither satisfied or dissatisfied
Satisfied
Very Satisfied
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Not Satisfied
Somewhat Satisfied
Neither satisfied or dissatisfied
Satisfied
Very Satisfied
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4
How easy or difficult was it to schedule your appointment at a time that was convenient for you?
Very difficult
Somewhat difficult
Neither difficult or easy
Somewhat easy
Very easy
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Very difficult
Somewhat difficult
Neither difficult or easy
Somewhat easy
Very easy
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5
How convenient was the appointment time your were able to get?
Not at all convenient
Not so convenient
Somewhat convenient
Very convenient
Extremely convenient
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Not at all convenient
Not so convenient
Somewhat convenient
Very convenient
Extremely convenient
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6
Overall, how would you rate the service you received from the staff at our office?
Poor
Fair
Good
Very good
Excellent
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Poor
Fair
Good
Very good
Excellent
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7
Did your appointment with your provider start early, late, or on time?
Very late
Somewhat late
On time
Somewhat early
Very early
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Very late
Somewhat late
On time
Somewhat early
Very early
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8
Overall, how would you rate the care you received from your provider?
Poor
Fair
Good
Very good
Excellent
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Poor
Fair
Good
Very good
Excellent
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9
How well did your provider listen to your needs?
Not at all well
Not so well
Somewhat well
Very well
Extremely well
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Not at all well
Not so well
Somewhat well
Very well
Extremely well
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10
How well did your provider answer your questions?
Not at all well
Not so well
Somewhat well
Very well
Extremely well
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Not at all well
Not so well
Somewhat well
Very well
Extremely well
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11
In the last 12 months, how often did your provider seem informed and up-to-date about the care you got from specialists?
Never
Rarely
Sometimes
Most of the time
Always
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Never
Rarely
Sometimes
Most of the time
Always
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Should be Empty: