Patient Satisfaction Survey

* How often do you come to our clinic?

This is my first visit

More than once a month

Every one or two months

Every three or four months

Once or twice per year

* How satisfied are you with the care you receive at our office?

* Do you wait too long to see our doctors?

How long do you think your office visit should last?(from the time you check in until you leave)

Less than 30 minutes

Between 30 minutes and 1 hour

Between 1 hour and 1 1/2 hours

Between 1 1/2 hours and 2 hours

Don't Care

* Please check any part(s) of your visit today that seemed too slow.

Check in at the front desk

Waiting room

Nurses area( for blood pressure, weight)

Wait in exam room before you see the doctor

The doctor visit

Check out desk

The lab visit

The xray visit

Please make any other comments/suggestions below

Untitled