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Frequently Accessed Resources

Patient Satisfaction Survey

We would appreciate you taking the time to let us know how we served you. Simply fill out the form below and click submit when you are done. We do not ask for your identity on this form. It is simply for you to tell us your opinions.

Please specify the physician that you have seen:
*

Please specify the location you have visited:
*

Promptness in scheduling of your appointment:
 Excellent Very good Satisfactory Below average Poor

Friendliness of staff:

Physician:
Excellent Very good Satisfactory Below average Poor

Office staff:
Excellent Very good Satisfactory Below average Poor

Personnel:
Excellent Very good Satisfactory Below average Poor

General Office Visit

Promptness of answering phone:
Excellent Very good Satisfactory Below average Poor

Promptness of the nurse or physician returning your phone call:
Excellent Very good Satisfactory Below average Poor

Time spent waiting in our office:
Excellent Very good Satisfactory Below average Poor

Overall comfort with our office staff:
Excellent Very good Satisfactory Below average Poor

Tests and procedures explained in understandable terms:
Excellent Very good Satisfactory Below average Poor

Explanation of your illness and treatment:
Excellent Very good Satisfactory Below average Poor

Our staff's understanding of your insurance benefits:
Excellent Very good Satisfactory Below average Poor

Convenience of our office hours:
Excellent Very good Satisfactory Below average Poor

Convenience of our office locations:
Excellent Very good Satisfactory Below average Poor

Amount of time waiting for the physician:
Excellent Very good Satisfactory Below average Poor

Amount of time the physician spent with you:
Excellent Very good Satisfactory Below average Poor

Professional manner of our office staff:
Excellent Very good Satisfactory Below average Poor

Your overall visit:
Excellent Very good Satisfactory Below average Poor

What do you like best about our office?

What do you like least about our office?

What suggestions do you have that might help us server you better?

Would you like a return phone call regarding this visit?  Yes No
If yes, please enter your phone number with area code where we can reach you?