Idaho Pain Clinic Post-Visit Patient Satisfaction

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* 1. Which location were you seen at?

Sandpoint

Lewiston

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* 2. How was your experience with the appointment process?

	Very Satisfied	Satisfied	Average	Dissatisfied	Very Dissatisfied	N/A
Appointment available within a reasonable amount of time	Appointment available within a reasonable amount of time Very Satisfied	Appointment available within a reasonable amount of time Satisfied	Appointment available within a reasonable amount of time Average	Appointment available within a reasonable amount of time Dissatisfied	Appointment available within a reasonable amount of time Very Dissatisfied	Appointment available within a reasonable amount of time N/A
The efficiency of the check-in process	The efficiency of the check-in process Very Satisfied	The efficiency of the check-in process Satisfied	The efficiency of the check-in process Average	The efficiency of the check-in process Dissatisfied	The efficiency of the check-in process Very Dissatisfied	The efficiency of the check-in process N/A
Waiting time in the reception area	Waiting time in the reception area Very Satisfied	Waiting time in the reception area Satisfied	Waiting time in the reception area Average	Waiting time in the reception area Dissatisfied	Waiting time in the reception area Very Dissatisfied	Waiting time in the reception area N/A
Waiting time in the exam room	Waiting time in the exam room Very Satisfied	Waiting time in the exam room Satisfied	Waiting time in the exam room Average	Waiting time in the exam room Dissatisfied	Waiting time in the exam room Very Dissatisfied	Waiting time in the exam room N/A
Answering phone calls during business hours	Answering phone calls during business hours Very Satisfied	Answering phone calls during business hours Satisfied	Answering phone calls during business hours Average	Answering phone calls during business hours Dissatisfied	Answering phone calls during business hours Very Dissatisfied	Answering phone calls during business hours N/A
Returning your messages	Returning your messages Very Satisfied	Returning your messages Satisfied	Returning your messages Average	Returning your messages Dissatisfied	Returning your messages Very Dissatisfied	Returning your messages N/A
Helping you with your next appointment	Helping you with your next appointment Very Satisfied	Helping you with your next appointment Satisfied	Helping you with your next appointment Average	Helping you with your next appointment Dissatisfied	Helping you with your next appointment Very Dissatisfied	Helping you with your next appointment N/A

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* 3. How was your experience with our staff?

	Very Satisfied	Satisfied	Average	Dissatisfied	Very Dissatisfied	N/A
The friendliness and courtesy of the receptionist	The friendliness and courtesy of the receptionist Very Satisfied	The friendliness and courtesy of the receptionist Satisfied	The friendliness and courtesy of the receptionist Average	The friendliness and courtesy of the receptionist Dissatisfied	The friendliness and courtesy of the receptionist Very Dissatisfied	The friendliness and courtesy of the receptionist N/A
The caring concern of our nurses/medical assistants	The caring concern of our nurses/medical assistants Very Satisfied	The caring concern of our nurses/medical assistants Satisfied	The caring concern of our nurses/medical assistants Average	The caring concern of our nurses/medical assistants Dissatisfied	The caring concern of our nurses/medical assistants Very Dissatisfied	The caring concern of our nurses/medical assistants N/A
The helpfulness of the people who assisted you with billing or insurance	The helpfulness of the people who assisted you with billing or insurance Very Satisfied	The helpfulness of the people who assisted you with billing or insurance Satisfied	The helpfulness of the people who assisted you with billing or insurance Average	The helpfulness of the people who assisted you with billing or insurance Dissatisfied	The helpfulness of the people who assisted you with billing or insurance Very Dissatisfied	The helpfulness of the people who assisted you with billing or insurance N/A

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* 4. Which provider did you see?

Sorin Ispirescu, M.D.

Leslie Rogers, NP-C

Matthew Hansen, PA-C

Amber Farance, PA-C

Graham Andrews, FNP-C

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* 5. Did your appointment with your provider start early, late or on time?

Very early

Somewhat early

On time

Somewhat late

Very late

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* 6. How was your experience with the provider?

	Very Satisfied	Satisfied	Average	Dissatisfied	Very Dissatisfied
Listening to your concerns, questions, comments	Listening to your concerns, questions, comments Very Satisfied	Listening to your concerns, questions, comments Satisfied	Listening to your concerns, questions, comments Average	Listening to your concerns, questions, comments Dissatisfied	Listening to your concerns, questions, comments Very Dissatisfied
Receiving a clear explanation of treatment options and follow-up care	Receiving a clear explanation of treatment options and follow-up care Very Satisfied	Receiving a clear explanation of treatment options and follow-up care Satisfied	Receiving a clear explanation of treatment options and follow-up care Average	Receiving a clear explanation of treatment options and follow-up care Dissatisfied	Receiving a clear explanation of treatment options and follow-up care Very Dissatisfied
Spent sufficient amount of time during your visit	Spent sufficient amount of time during your visit Very Satisfied	Spent sufficient amount of time during your visit Satisfied	Spent sufficient amount of time during your visit Average	Spent sufficient amount of time during your visit Dissatisfied	Spent sufficient amount of time during your visit Very Dissatisfied
Advice given to you on ways to stay healthy	Advice given to you on ways to stay healthy Very Satisfied	Advice given to you on ways to stay healthy Satisfied	Advice given to you on ways to stay healthy Average	Advice given to you on ways to stay healthy Dissatisfied	Advice given to you on ways to stay healthy Very Dissatisfied
Overall, how satisfied are you with the care you received	Overall, how satisfied are you with the care you received Very Satisfied	Overall, how satisfied are you with the care you received Satisfied	Overall, how satisfied are you with the care you received Average	Overall, how satisfied are you with the care you received Dissatisfied	Overall, how satisfied are you with the care you received Very Dissatisfied

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* 7. How likely is it that you would recommend our clinic to a friend or colleague?

NOT AT ALL LIKELY

EXTREMELY LIKELY

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10

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1

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10

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* 8. Is there anything we could have done to improve your last visit?

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* 9. Are there new services that you would like to see us add?