PATIENT SATISFACTION SURVEY

How satisfied are you with the following? Please select the number you feel, in your opinion, about our clinic for each line or number below. Please feel free to comment at the bottom!


Very
Dissatisfied
Satisfied
Very
Satisfied
01. Ease of making appointment for checkups (Physicals, well visits, routine, etc.)
02. Ease of making appointments for acute sickness?
03. Waiting time in our office?
04. Your phone calls handled in a prompt and courteous manner?
05. Ease in reaching a doctor on call weekends and nights?
06. The time it takes someone from our office to respond when you call the office with an urgent problem?
07. Are our receptionists/operators friendly & courteous?
08. Are our nurses/lab personnel friendly, courteous and professional?
09. Our office's appearance (Cleanliness, appearance, etc.)
10. Our Office's convenience (location, parking, hours, office layout)?
11. The way we teach you about improving your health?
12. How satisfied are you with our insurance filing & monthly statements?
13. How caring is our office staff?
14. The charges for services (our fees)?

 

PHYSICIANS SERVICES

Have Not
Seen
Very
Dissatisfied
Satisfied
Very
Satisfied
15. Ease in speaking with your doctor by telephone when you call during business hours? Barratt
Lawrence
Loper








16. Your doctor seeing you in a reasonable time after your appointment time? Barratt
Lawrence
Loper








17. Your doctor taking time to answer your questions? Barratt
Lawrence
Loper








18. Ease in obtaining follow-up information and care (test results, medicines, care instructions, etc.)? Barratt
Lawrence
Loper








19. The way your doctor involves other physicians and care givers in your care when needed? Barratt
Lawrence
Loper








20. How satisfied are you with the medical decision making and treatment of your doctor? Barratt
Lawrence
Loper








21. Would you recommend your doctor to your family or friends? Barratt
Lawrence
Loper








22. Overall how would you rate clinic & physicians?

Comments: (Please be specific, as it could help us solve problems we may not be aware of!)

 


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© Broken Bow Clinic, P.C., 2008