Patient Satisfaction Survey v05E Question Title * 1. Are you a new patient at BCFHC? Yes No OK Question Title * 2. Where did you access care today? Hollywood Lauderhill Pompano Beach Dental - Pompano Beach West Park via Telehealth OK Question Title * 3. How easy was it to schedule your appointment? Very Easy Easy Hard Very Hard Very Easy Easy Hard Very Hard OK Question Title * 4. Who was the provider that saw you today? Dr. Chery Dr. Barros Dr. Hossain Dr. Gotrace Dr. Steinberg (PEDS) Ms. Adesca Ms. Almaral Ms. Hall Ms. Mekic-Ruiz Ms. Maxton Ms. Cleophat Mr. Georges Ms. Yu Ms. Appel (Dietitian) Ms. Hines (LCSW) Dr. Alvarez (Behavioral Health) Ms. Delgado Dr. Williams Dr. Salas (Dentist) Dr. Trenkova (Dentist) Ms. Viltres (Dental Hygienist) Other (please specify) OK Question Title * 5. How would you rate the overall care you received from your provider? Very Good Good Poor Very Poor Very Good Good Poor Very Poor OK Question Title * 6. How well do you understand the information you received regarding the your care/treatment plan (i.e., medications, ongoing care & goals, follow-up, and/or referrals): Very Well Well Somewhat Not at All Very Well Well Somewhat Not at All OK Question Title * 7. How likely are you to recommend BCFHC to family or friends? Very Likely Likely Unlikely Very Unlikely Very Likely Likely Unlikely Very Unlikely OK Question Title * 8. Is there any staff member who you would like to recognize for providing exceptional service during today's visit? (Optional) OK Question Title * 9. How might we improve your overall experience at our health center? List any comments or concerns. (Optional) OK Question Title * 10. What is your age range? 20 and below 21 to 30 31 to 40 41 to 50 51 to 60 61 to 70 71+ OK DONE
