Patient Satisfaction Survey - SISC Please take a few minutes and tell us how we are doing by completing our Patient Satisfaction Survey. We strive in providing superior, state-of-the art care to our patients. Your input is very important in an effort to improve the quality of our services. We appreciate your time and feedback. Step 1 of 3 33% Scheduling your appointmentHow soon were you called after your request?*Within 1 working dayWithin 2 working daysI did not receive a return callWe strive to be prompt, however sometimes technology fails. We apologize for any delay or you not receiving a return call. Ease of scheduling your appointment*ExcellentVery GoodGoodFairPoorNot ApplicableCourtesy of the staff who answered your call*ExcellentVery GoodGoodFairPoorNot ApplicablePromptness in returning your call*ExcellentVery GoodGoodFairPoorNot Applicable Arrival, Check-In and Wait TimeEase at finding our office and parking*ExcellentVery GoodGoodFairPoorNot ApplicableStaff courtesy and helpfulness upon arrival*ExcellentVery GoodGoodFairPoorNot ApplicableComfort in waiting area*ExcellentVery GoodGoodFairPoorNot ApplicableWere you seen within a reasonable time*ExcellentVery GoodGoodFairPoorNot ApplicableCommunication about delay, if any*ExcellentVery GoodGoodFairPoorNot ApplicablePatient Care Services / ExaminationHow long was your wait?*15 min30 min45 min60 minOver an hourPromptness of returning your phone calls*ExcellentVery GoodGoodFairPoorNot ApplicableCourtesy and helpfulness of our clinical staff*ExcellentVery GoodGoodFairPoorNot ApplicableWas our staff knowledgeable in answering your questions?*ExcellentVery GoodGoodFairPoorNot ApplicableCourtesy of the doctor treating you*ExcellentVery GoodGoodFairPoorNot ApplicableHow clearly did your doctor explain your exam/results and treatment?*ExcellentVery GoodGoodFairPoorNot ApplicableHelpfulness of educational materials provided*ExcellentVery GoodGoodFairPoorNot Applicable Billing, Check-out and Follow-upCourtesy and helpfulness of our check-out staff*ExcellentVery GoodGoodFairPoorNot ApplicableEase of scheduling your follow-up appointment*ExcellentVery GoodGoodFairPoorNot ApplicableCourtesy and helpfulness of your account representative*ExcellentVery GoodGoodFairPoorNot ApplicableEffectiveness in explaining charges*ExcellentVery GoodGoodFairPoorNot ApplicableWould you like us to contact you to discuss any issues? (Optional)* Yes No Your relationship with your doctor is one of the most important you have. While visiting your doctor there's a lot of information to process, protocols and insurance to deal with. We genuinely care about your experience and would like feedback from you on how to improve your time with us. We Care! Name* First Last Phone*Secure Entry Federal and State Health Privacy and Security Notice: Please keep in mind that communications via email over the internet are not secure. Although it is unlikely, there is a possibility that information you include in an email can be intercepted and read by other parties besides the person to whom it is addressed. Please do not include personal identifying information such as your birth date, or personal medical information in any emails you send to us. No one can diagnose your condition from email or other written communications, and communication via our website cannot replace the relationship you have with your physician. ~ Thank you!
