Thank you for being a patient of Redlands Family Practice. Please take a moment to let us know how we are doing by checking the answer that best matches your experience, any additional comments and click at the bottom of the page to submit your responses. Your responses will help us improve the care your receive here at Redlands Family Practice. Please be assured this information is kept strictly confidential and we are only asking questions to measure your satisfaction with the services provided.

Please rate your experiences on a scale of 5 - 1:

1. Physician:

	Manuel A. Cantun, MD	Henry M. Chai, MD	Alexander Terrazas, MD	Maria Elena Terrazas, PA-C
Please select	Physician: Please select Manuel A. Cantun, MD	Please select Henry M. Chai, MD	Please select Alexander Terrazas, MD	Please select Maria Elena Terrazas, PA-C

2. Telephone call answered promptly and professionally?

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	Telephone call answered promptly and professionally? Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

3. The amount of time it took to obtain the appointment with the Primary Care Physician:

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	The amount of time it took to obtain the appointment with the Primary Care Physician: Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

4. The convenience of parking and access to the office building:

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	The convenience of parking and access to the office building: Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

5. Was the reception staff friendly and courteous?

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	Was the reception staff friendly and courteous? Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

6. The waiting time in the reception area:

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	The waiting time in the reception area: Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

7. The appearance and cleanliness of the office:

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	The appearance and cleanliness of the office: Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

8. Was the Nursing staff friendly and knowledgeable?

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	Was the Nursing staff friendly and knowledgeable? Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

9. Did the doctor listen carefully to your concerns?

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	Did the doctor listen carefully to your concerns? Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

10. Was the doctor's explanation of your medical problems and treatment plan clear and understandable?

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	Was the doctor's explanation of your medical problems and treatment plan clear and understandable? Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

11. Did you receive the results of your test in a timely manner?

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	Did you receive the results of your test in a timely manner? Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

12. Overall Quality of medical care:

	5 = Superior	4 = Excellent	3 = Good	2 = Fair	1 = Poor
Please select	Overall Quality of medical care: Please select 5 = Superior	Please select 4 = Excellent	Please select 3 = Good	Please select 2 = Fair	Please select 1 = Poor

13. Comments (optional):

Comments (optional):

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