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Patient Survey

    PLEASE RATE THE FOLLOWING:
    Excellent Good Fair Poor Very Poor
    5 4 3 2 1

    A. YOUR APPOINTMENT:

    1. Welcomed, as I walked in, by the receptionist.
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    2. The check in process was efficient.
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    3. Time spent waiting in the lobby.
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    4. Time spent waiting in the exam room.
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    B. OUR STAFF

    1. Valued me as a customer.
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    2. Exceeded my expectations
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    3. Knowledgeable, skilled, and confident
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    4. Informed me of delays.
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    5. Maintained my modesty.
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    C. OUR PROVIDER:

    1. Listened and answered all my questions.
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    2. Involved me with decisions regarding my health.
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    3. Clearly explained my diagnosis and treatment plan.
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    4. Delivered excellent bedside manner.
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    D. OUR FACILITY:

    1. Has convenient hours of operation.
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    2. Was clean and organized.
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    3. Is a trusted clinic in the community.
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    4. Is in a convenient location easily found.
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    E. YOUR OVERALL SATISFACTION:

    1. Of the practice.
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    2. The quality of your medical care.
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    3. Overall rating of care you received
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    HOW LIKELY WILL YOU RECOMMEND FIRST CARE TO OTHERS?
    DefinitelyMaybeDefinitely Not

    PLEASE TELL US WHY?

    IF THERE IS A WAY WE CAN IMPROVE OUR SERVICES, PLEASE TELL US ABOUT IT?

    HOW DID YOU HEAR ABOUT FIRST CARE?
    INTERNETRADIOYELLOW PAGESDRIVE BYFRIENDOTHER




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