Sheridan Memorial Rural Health Clinic Services
440 West Laurel Avenue Plentywood, MT 59254
Your assistance in completing the survey will allow SMC to provide quality care to the community we serve.
OK
1.
Which provider did you see?
Carlos Trevino, MD
David Shahbodaghi, MD
Kelsey Haugo, FNP
Brit Nyby, PA-C
Jennifer Hoversland, FNP
Stephanie Kanning, FNP
Elizabeth Kleppen, PA
Other (please specify)
2.
How would you rate the confidentiality of:
Very Good
Good
Fair
Poor
Very Poor
N/A
Receptionists
Very Good
Good
Fair
Poor
Very Poor
N/A
Nurses/Clinical Staff
Very Good
Good
Fair
Poor
Very Poor
N/A
Providers: MD, FNP, PA
Very Good
Good
Fair
Poor
Very Poor
N/A
Office Staff/Billing Services
Very Good
Good
Fair
Poor
Very Poor
N/A
Comments:
3.
How would you rate the following?
Very Good
Good
Fair
Poor
Very Poor
N/A
Convenience of office hours.
Very Good
Good
Fair
Poor
Very Poor
N/A
Comfort of reception area.
Very Good
Good
Fair
Poor
Very Poor
N/A
Comfort of exam rooms.
Very Good
Good
Fair
Poor
Very Poor
N/A
Comments:
4.
Please rate our Reception and Office Staff
Very Good
Good
Fair
Poor
Very Poor
N/A
How were you treated when you last telephoned our office?
Very Good
Good
Fair
Poor
Very Poor
N/A
How were you treated by the registration staff at the time of your visit?
Very Good
Good
Fair
Poor
Very Poor
N/A
How were you treated when making a follow up appointment?
Very Good
Good
Fair
Poor
Very Poor
N/A
Regarding your account, how were you treated by the billing staff?
Very Good
Good
Fair
Poor
Very Poor
N/A
How would you rate the billing statements. Are they easy to read and understand?
Very Good
Good
Fair
Poor
Very Poor
N/A
Comments:
5.
Please rate our Providers, Nurses and Clinical Assistants
Very Good
Good
Fair
Poor
Very Poor
N/A
How would you rate the nurse or clinical assistant as being professional and courteous?
Very Good
Good
Fair
Poor
Very Poor
N/A
Provider's explanation of your condition, test and treatment.
Very Good
Good
Fair
Poor
Very Poor
N/A
Reporting of the test results.
Very Good
Good
Fair
Poor
Very Poor
N/A
Willingness of provider to answer your questions.
Very Good
Good
Fair
Poor
Very Poor
N/A
If you have called the nurse, clinical assistant or provider with question, how do you feel the response time was?
Very Good
Good
Fair
Poor
Very Poor
N/A
Comments:
6.
Overall Care at Sheridan Memorial Clinic
Very Good
Good
Fair
Poor
Very Poor
N/A
Overall professionalism and care at our facility.
Very Good
Good
Fair
Poor
Very Poor
N/A
Comments:
7.
Would you recommend the facility to others?
Yes
No
Comments:
8.
What one thing do you most like about our practice?
9.
How can we improve our service?
Current Progress,
0 of 9 answered