Screen Reader Mode Icon

Question Title

* 1. Please rate your overall experience today

Question Title

* 2. Which provider did you see today?

Question Title

* 3. When making your appointment, were you given a chance to see your primary care provider?

Question Title

* 4. How satisfied were you with the appointment time you were able to get?

Question Title

* 5. How satisfied were you with the following?

  1 Not satisfied at all 2 3 4 5 Extremely satisfied N/A
Front desk staff knowledge & friendliness
Nursing staff knowledge & friendliness
Provider knowledge & friendliness
Cleanliness of the clinic

Question Title

* 6. How would you rate the length of time you spent waiting during today's visit?

Question Title

* 7. How satisfied were you with the amount of time your provider spent with you addressing your needs?

Question Title

* 8. Is there anyone on our team you would like to recognize or thank for how they cared for you today?

Question Title

* 9. Are any of these keeping you from reaching your physical and mental wellness goals?

Question Title

* 10. Is there anything we could have done to improve your visit today?

0 of 10 answered
 

T