Patient Satisfaction Survey

1. My Appointment was made within a reasonable amount of time:
Strongly Agree    Agree    Neutral    Disagree    Strongly Disagree   
 
2. The receptionist/office staff were helpful and courteous.
Strongly Agree    Agree    Neutral    Disagree    Strongly Disagree   
 
3. My appointment started on time.
Strongly Agree    Agree    Neutral    Disagree    Strongly Disagree   
 
4. The nurse/assistance was helpful and courteous.
Strongly Agree    Agree    Neutral    Disagree    Strongly Disagree   
 
5. The physician or nurse practitioner treated me with respect and concern.
Strongly Agree    Agree    Neutral    Disagree    Strongly Disagree   
 
6. The physician or nurse practitioner adequately addressed my questions and gave understandable answers.
Strongly Agree    Agree    Neutral    Disagree    Strongly Disagree   
 
7. I am satisfied with the thoroughness and completeness of my medical treatment.
Strongly Agree    Agree    Neutral    Disagree    Strongly Disagree   
 
8. I was given appropriate instruction regarding future appointments or follow up care.
Strongly Agree    Agree    Neutral    Disagree    Strongly Disagree   
 
9. Overall, I was pleased with my visit.
Strongly Agree    Agree    Neutral    Disagree    Strongly Disagree   
 
10. Why did you choose this clinic?
Recommended/Reputation    Advertisement    Nearest Location    Other