Patient Satisfaction Survey for Laurel Endocrine & Thyroid Specialists, PA

Patient Satisfaction Survey for Laurel Endocrine & Thyroid Specialists, PA
Please complete this survey about your recent visit. For each question, indicate your response (1–5) where 5 = Excellent (Highly Satisfied) and 1 = Poor (Very Dissatisfied).
Name of the Doctor this survey is about:
Ease of scheduling your appointment:

1

2

3

4

5

1 is 1 (Poor/Very Dissatisfied), 5 is 5 (Excellent/Highly Satisfied)
Courtesy and helpfulness of the staff:

1

2

3

4

5

1 is 1 (Poor/Very Dissatisfied), 5 is 5 (Excellent/Highly Satisfied)
Waiting time in the office:

1

2

3

4

5

1 is 1 (Poor/Very Dissatisfied), 5 is 5 (Excellent/Highly Satisfied)
Cleanliness and comfort of the office:

1

2

3

4

5

1 is 1 (Poor/Very Dissatisfied), 5 is 5 (Excellent/Highly Satisfied)
Doctor’s ability to listen to your concerns:

1

2

3

4

5

1 is 1 (Poor/Very Dissatisfied), 5 is 5 (Excellent/Highly Satisfied)
Doctor’s explanations of your condition and treatment:

1

2

3

4

5

1 is 1 (Poor/Very Dissatisfied), 5 is 5 (Excellent/Highly Satisfied)
Doctor’s respect for your questions and opinions:

1

2

3

4

5

1 is 1 (Poor/Very Dissatisfied), 5 is 5 (Excellent/Highly Satisfied)
Would you recommend our practice to others?

1

2

3

4

5

1 is 1 (Poor/Very Dissatisfied), 5 is 5 (Excellent/Highly Satisfied)
What did you like best about your visit?
What can we do to improve your experience?
Should be Empty: