Patient Satisfaction Survey

1. How would you rate our phone menu and the ease at which you were able to reach our Appointment Scheduler?
    Good    Average    Poor
2. How would you rate the Scheduler’s professionalism, helpfulness and courtesy?
    Good    Average    Poor
3. Were you able to get an Appointment when you wanted one?
    Good    Average    Poor
4. How would you rate the appearance of our Reception Area?
    Good    Average    Poor
5. How would you rate the Wait Time in our Reception Area?
    Good    Average    Poor
6. How would you rate the care you received from our Nursing and Technical Staff?
    Good    Average    Poor
7. How would you rate the care you received from your Physician?
    Good    Average    Poor
8. Would you refer your family/friends to this practice?
    Yes    No
9. Overall, how would you rate your visit to our office?
    Good    Average    Poor

Please feel free to add any additional comments, complaints or recommendations below: