Patient Survey

Which physician did you see for your appointment?

* Which physician did you see for your appointment?

* YOUR APPOINTMENT:

Strongly Disagree Disagree No Opinion Agree Strongly Agree
Ease of making appointments by phone
The efficiency of the check in process
Waiting time in the reception area
Keeping you informed if your appointment time was delayed
* OUR STAFF:

Strongly Disagree Disagree No Opinion Agree Strongly Agree
The friendliness of the person you spoke with over the phone
The friendliness and courtesy of the check-in person
The helpfulness of the person who assisted you with billing/insurance
* OUR COMMUNICATION WITH YOU:

Strongly Disagree Disagree No Opinion Agree Strongly Agree
Your phone call answered promptly
Explanation of your procedure
Our ability to return your call in a timely manner
* YOUR VISIT WITH THE PROVIDER (MD & PA):

Strongly Disagree Disagree No Opinion Agree Strongly Agree
Willingness to listen carefully to you
Taking time to answer your questions
Explaining things in a way you could understand
* YOUR OVERALL SATISFACTION WITH:

Strongly Disagree Disagree No Opinion Agree Strongly Agree
Our practice
Overall rating of your physician and/or physician assistant
* Are you a:

* Would you recommend your provider to others?

* Please let us know if there is any way we can improve our services to you: