Patient Satisfaction Survey

Please rank your satisfaction with our services in the following areas: (A rating of "1" means you were extremely dissastisfied.  A rating of "5" means you were extremely satisfied.)

Access To Care:   Length of time it took to get an appointment  1 2 3 4 5   Length of time spent in office waiting to be seen  1 2 3 4 5   Physical environment of office   1 2 3 4 5

Communication Between Patient and Practice:   Ability to get through via phone when contacting practice  1 2 3 4 5   Efficiency in receiving test results  1 2 3 4 5   Quality of helath information handout materials  1 2 3 4 5

Interaction with Office Staff:   Courtesy of reception staff  1 2 3 4 5   Friendliness and helpfulness of medical assistants and nurses  1 2 3 4 5   Helpfulness of staff in the business office   1 2 3 4 5

Interaction with Physician/Practitioner:   Friendliness and helpfulness of medical assistants and nurses  1 2 3 4 5     Thoroughness of explanations and instructions 1 2 3 4 5   Taking time to answer questions  1 2 3 4 5

Overall Satisfaction: Overall, how satisfied are you with the practice? 1 2 3 4 5

1. How did you hear about our practice?

2. What do you like best about our practice?

3. What can we do to improve?

4. Would you reccomend this practice to family or friends? Yes   No