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Patient Satisfaction Survey
Submitted by admin on Tue, 01/12/2010 - 15:47
We would like to know how you feel about the services we provide so we can make sure we are meeting your needs. Your responses are appreciated and will be used for improving these services.
Thank you for your time.
Which office do you normally see us in:
*
345 Cypress Creek, Cedar Park
12176 N. Mopac, Austin
16020 Park Valley Dr., Round Rock
4112 Links Lane, Round Rock
Which provider do you most frequently see:
*
Humayun Beg, MD
Jay Borick, MD
Marco Bosquez, MD
Brent Brotzman, MD
Jeffery DeLoach, DO
John Duggan, MD
David Gillory III, MD
Robert Graham, MD
Jennifer Lord, MD
Mark Parrella, MD
Michael Putney, MD
Mustasim Rumi, MD
Michael Valastro, MD
Steve Wilson, MD
Stephen Griffin, PA-C
Gregg Langston, PA-C
Staci Reese, PA-C
Terry Smith, PA-C
A. YOUR APPOINTMENT:
*
Great
Good
OK
Fair
Poor
N/A
Ease of making appointments by phone
Appointment available within a reasonable amount of time
Getting care for your illness/injury as soon as you wanted it
Getting after-hours care when you needed it
The efficiency of the check-in process
Waiting time in the reception area
Waiting time in the exam room
Keeping you informed if your appointment time was delayed
B. OUR STAFF:
*
Great
Good
OK
Fair
Poor
N/A
The courtesy of the person who took your call
The friendliness and courtesy of the receptionist
The caring concern of our medical assistants
The helpfulness of the people who assisted you with billing or insurance
The professionalism of our x-ray staff
C. OUR COMMUNICATION WITH YOU:
*
Great
Good
OK
Fair
Poor
N/A
Your phone calls answered promptly
Getting advice or help when needed during office hours
Explanation of your procedure
Your test results reported in a reasonable amount of time
Our ability to return your calls in a timely manner
Your ability to contact us after hours
Your ability to obtain prescription refills by phone
D. YOUR VISIT WITH THE PROVIDER:
*
Great
Good
OK
Fair
Poor
N/A
Willingness to listen carefully to you
Taking time to answer your questions
Amount of time spent with you
Explaining things in a way you could understand
Instructions regarding medications/follow-up care
The thoroughness of the examination
E. OUR FACILITIES:
*
Great
Good
OK
Fair
Poor
N/A
Comfort and cleanliness
Ease of locating office
Adequate parking
Hours of operation convenient for you
Signage and directions easy to follow
F. YOUR OVERALL SATISFACTION WITH:
*
Great
Good
OK
Fair
Poor
N/A
The services we provide and your experience at our office
The likelihood of referring your friends and relatives to us
Additional Comments (Optional):
Name (Optional):
Email (Optional):
Phone Number (Optional):
Gender:
Male
Female
Your Age:
Under 18
18-30
31-40
41-50
51-60
Over 60
Are you::
A new patient
A returning patient