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* 1. Overall, how satisfied or dissatisfied were you with your last visit to our office?

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* 2. Overall, how would you rate the service you received from the staff at our office?

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* 3. I was offered an appointment that was suitable for my schedule.

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* 4. I feel I have adequate access to care with my provider.

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* 5. Overall, how would you rate the care you received from your provider?

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* 6. How much do you trust your provider to make medical decisions that are in your best interests?

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* 7. My provider listened to my needs & answered my questions.

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* 8. My provider explained my treatment options & follow up care.

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* 9. Overall, I am satisfied with the communication from my provider.

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* 10. I would rate my satisfaction with the online patient portal as:

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* 11. I received a same day appointment with my complaint.

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* 12. Please share any other comments you have below:

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