Patient Satisfaction Survey 2019 Question Title * 1. Which office did you visit? Elkhart - Bristol St Elkhart - Old US 20 Goshen Middlebury Mishawaka South Bend Question Title * 2. Reason for visit today: First visit - injury Physical Examination Return visit - injury Other (please specify): Please mark the response that best describes your opinion about your experience today: Question Title * 3. The front office staff: Strongly agree Agree Neutral Disagree Strongly disagree greeted you promptly and in a friendly manner greeted you promptly and in a friendly manner Strongly agree greeted you promptly and in a friendly manner Agree greeted you promptly and in a friendly manner Neutral greeted you promptly and in a friendly manner Disagree greeted you promptly and in a friendly manner Strongly disagree was knowledgeable and professional was knowledgeable and professional Strongly agree was knowledgeable and professional Agree was knowledgeable and professional Neutral was knowledgeable and professional Disagree was knowledgeable and professional Strongly disagree Question Title * 4. The clinical staff: Strongly agree Agree Neutral Disagree Strongly disagree was courteous and treated me with respect was courteous and treated me with respect Strongly agree was courteous and treated me with respect Agree was courteous and treated me with respect Neutral was courteous and treated me with respect Disagree was courteous and treated me with respect Strongly disagree listened to my concerns listened to my concerns Strongly agree listened to my concerns Agree listened to my concerns Neutral listened to my concerns Disagree listened to my concerns Strongly disagree was knowledgeable and professional was knowledgeable and professional Strongly agree was knowledgeable and professional Agree was knowledgeable and professional Neutral was knowledgeable and professional Disagree was knowledgeable and professional Strongly disagree Question Title * 5. The provider: Strongly agree Agree Neutral Disagree Strongly disagree was courteous and treated me with respect was courteous and treated me with respect Strongly agree was courteous and treated me with respect Agree was courteous and treated me with respect Neutral was courteous and treated me with respect Disagree was courteous and treated me with respect Strongly disagree listened to my concerns listened to my concerns Strongly agree listened to my concerns Agree listened to my concerns Neutral listened to my concerns Disagree listened to my concerns Strongly disagree answered my questions answered my questions Strongly agree answered my questions Agree answered my questions Neutral answered my questions Disagree answered my questions Strongly disagree was knowledgeable and professional was knowledgeable and professional Strongly agree was knowledgeable and professional Agree was knowledgeable and professional Neutral was knowledgeable and professional Disagree was knowledgeable and professional Strongly disagree Question Title * 6. Overall: Strongly agree Agree Neutral Disagree Strongly disagree I was seen in a reasonable amount of time I was seen in a reasonable amount of time Strongly agree I was seen in a reasonable amount of time Agree I was seen in a reasonable amount of time Neutral I was seen in a reasonable amount of time Disagree I was seen in a reasonable amount of time Strongly disagree I am satisfied with the care I received I am satisfied with the care I received Strongly agree I am satisfied with the care I received Agree I am satisfied with the care I received Neutral I am satisfied with the care I received Disagree I am satisfied with the care I received Strongly disagree I would recommend this clinic to others I would recommend this clinic to others Strongly agree I would recommend this clinic to others Agree I would recommend this clinic to others Neutral I would recommend this clinic to others Disagree I would recommend this clinic to others Strongly disagree Question Title * 7. Comments: Done
