Patient Survey
We would like to know how you feel about the services we provide, so we can make sure we are meeting your needs. Your responses are directly responsible for improving these services. All responses will be kept confidential and anonymous. Thank you for your time. 5=Excellent; 4=Good; 3=Ok; 2=Fair; 1=Poor
Section 1 - Ease of Getting Care
Your call was answered promptly:
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2
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5
Worst
Best
1 is Worst, 5 is Best
First available appointment was reasonable:
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5
Worst
Best
1 is Worst, 5 is Best
Schedulers were friendly and helpful:
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5
Worst
Best
1 is Worst, 5 is Best
Appointment details were explained thoroughly:
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2
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5
Worst
Best
1 is Worst, 5 is Best
Section 2 - Checkin
Greeted with a smile and eye contact:
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2
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5
Worst
Best
1 is Worst, 5 is Best
Treated with compassion and understanding:
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2
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5
Worst
Best
1 is Worst, 5 is Best
Helpful and courteous:
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2
3
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5
Worst
Best
1 is Worst, 5 is Best
Informed of, in any, long wait times:
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2
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5
Worst
Best
1 is Worst, 5 is Best
Kept personal information private:
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5
Worst
Best
1 is Worst, 5 is Best
Section 3 - Provider:
Listened to you:
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2
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4
5
Worst
Best
1 is Worst, 5 is Best
Took enough time with you:
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2
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4
5
Worst
Best
1 is Worst, 5 is Best
Explained information thoroughly:
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2
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5
Worst
Best
1 is Worst, 5 is Best
Gave sound advice and treatment:
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5
Worst
Best
1 is Worst, 5 is Best
Section 4 - Nurses and Medical Assistants
Friendly and helpful:
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4
5
Worst
Best
1 is Worst, 5 is Best
Answered your questions:
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4
5
Worst
Best
1 is Worst, 5 is Best
Returned your phone call within a reasonable time:
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2
3
4
5
Worst
Best
1 is Worst, 5 is Best
Section 5 - Billing
Statements are easy to read:
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5
Worst
Best
1 is Worst, 5 is Best
Explanation of charges is clear:
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5
Worst
Best
1 is Worst, 5 is Best
Payment options and plans are offered if needed:
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2
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5
Worst
Best
1 is Worst, 5 is Best
Make a payment is easy:
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2
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5
Worst
Best
1 is Worst, 5 is Best
Billing staff is friendly and helpful:
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2
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4
5
Worst
Best
1 is Worst, 5 is Best
Section 6 - Facility
Building is neat and clean:
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5
Worst
Best
1 is Worst, 5 is Best
Location is convenient:
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5
Worst
Best
1 is Worst, 5 is Best
Waiting area is comfortable:
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2
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5
Worst
Best
1 is Worst, 5 is Best
Up-to-date reading material:
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5
Worst
Best
1 is Worst, 5 is Best
Refreshments available:
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5
Worst
Best
1 is Worst, 5 is Best
Section 7 - Overall Impression
The likelihood of referring your friends and family:
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2
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5
Worst
Best
1 is Worst, 5 is Best
What did you like the best about our group:
What did you like the least about our group:
Submit
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