PATIENT SATISFACTION SURVEY

1. We are interested in receiving your feedback about the care provided at our office. Please take a few minutes to complete this survey. Your responses are important to us. How satisfied are you with the following?

The promptness with which our telephones are answered?

 
 
 
 
 

2. Ease and availability of scheduling your appointment?

 
 
 
 
 

3. Friendliness and courtesy from the receptionist?

 
 
 
 
 

4. The comfort and cleanliness of the reception area and exam room?

 
 
 
 
 

5. Care and concern from the medical technicians?

 
 
 
 
 

6. The amount of time waiting to see your physician?

 
 
 
 
 

7. Physician explained things in a way that was easy to understand?

 
 
 
 
 

8. Satisfied with time spent with physician and thoroughness of exam?

 
 
 
 
 

9. The staff handled any billing or claim concerns in a way that was courteous and helpful?

 
 
 
 
 

10. Overall, how would you rate your experience?

 
 
 
 
 

11. Would you recommend this facility to friends and family?

 
 
 
 
 

12. Which office were you seen in today?

 
 
 
 

13. Which provider were you by today?

 
 
 
 
 
 
 
 
 

Question 1 of 13