Which physician did you see?

1. How long you waited to get an appointment?
Poor Fair Very Good Excellent

2. Convenience of the location of the office.
Poor Fair Very Good Excellent

3. Getting through to the office by phone.
Poor Fair Very Good Excellent

4. Length of time waiting at the office.
Poor Fair Very Good Excellent

5. Time spent with the physician you saw
Poor Fair Very Good Excellent

6. Explanation of what was done for you
Poor Fair Very Good Excellent

7. Technical skills (thoroughness, carefulness, competence)
of the physician you saw
Poor Fair Very Good Excellent

8. The personal manner (courtesy, respect, sensitivity, friendliness) of the physician you saw
Poor Fair Very Good Excellent

9. The visit overall
Poor Fair Very Good Excellent

10. Courtesy and helpfulness of the receptionist
Poor Fair Very Good Excellent

11. The personal manner (courtesy, respect, sensitivity, friendliness) of the nurse
Poor Fair Very Good Excellent

12. Quality of care of the nurse
Poor Fair Very Good Excellent

13. Staff's explanation of billing and payment insurance issues
Poor Fair Very Good Excellent

14. The likelihood of my recommending this physician and practice to a close friend or family member is:
Poor Fair Very Good Excellent

What can we do to improve? :



What do you like best about our practice? :


15. Would you like our office to get in touch with you about this survey?
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