Pre-NPE Workshop Team Survey
The completion of the following confidential survey helps me understand where you are today in your continuing journey toward excellence.
Name
First Name
Last Name
Preferred first name:
Doctors Name:
Office Phone:
Email:
Your Current role in the practice:
1. Do you currently have a Health Relationship/New Patient Coordinator?
Yes
No
1. Describe the current role/position of the person that handles New Patients:
2. If not, would you plan on developing one of your team members into this role?
Yes
No
Uncertain
Type a question
2. Please rank the following desired outcomes in YOUR order of importance:
3. Please list in order of importance your desired outcomes from this workshop:
4. Please list in order of importance your teams desired outcomes from this workshop:
5. Please list in order of importance your doctors desired outcomes from this workshop:
3. Describe your New Patient Exam:
6. Does your practice offer comprehensive new patient examinations?
Yes
No
Sometimes
% of the time?
7. If not, what is preventing it?
8. Briefly describe your new patient process:
4. How successful is your current process? What would you change?
10. What is working well?
11. What is not working as well as you'd like?
12. Briefly summarize your assessment of your continuing education or other post graduate training.
13. Are you currently enrolled in any ongoing post graduate training or do you intend to be in the next two years?
Yes
No
5. What other topics of continuing education are you interested in to help your New Patient Experience Implementation?
6. Other comments or information you would like our faculty to know?
Submit
Should be Empty: