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Your answers are confidential.

Who is your doctor?

At what location were you seen?

On a scale of one to ten, 10 being very satisfied, 1 being very dissatisfied, please answer the following:

1 2 3 4 5 6 7 8 9 10
1.     When calling our office, how long did it take to have your call answered?
3 rings or less... 6 rings or less... more than 7 rings...
     
2.    How easy was it to get an appointment?
     
3.   How satisfied were you with our front desk check-in staff?
     
4.   How satisfied were you with our medical staff, such as x-ray technicians, castroom technicians, medical assistants...?
     
5.   How long did you have to wait before you saw the doctor?
Less than 15 min... less than 30 min... more than 30 min...
     
6.   Were your questions answered by your physician?
Yes... Partly... Not at all...
     
7.   How would you rate your overall experience?
Additional Comments:

Thank you. Your answers will help us improve our service. Please call our office if you have any questions. Thank you again.