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Post-Visit Patient Satisfaction

1.Who is your provider for today's visit?(Required.)
2.
On a scale of 0 to 10,
How likely is it that you would recommend your provider to a friend or family member?
0 for Not at all likely, 10 for Extremely likely
Not at all likelyExtremely likely
3.Overall, how satisfied or dissatisfied were you with your last visit to our office?
4.How easy or difficult was it to schedule your appointment at a time that was convenient for you?
5.How convenient was the appointment time you were able to get?
6.In your opinion, how convenient is the location of our office?
7.Overall, how would you rate the service you received from the staff at our office?
8.How comfortable was the lobby and waiting area?
9.Did your appointment with your provider start early, late or on time?
10.Overall, how would you rate the care you received from your provider?
11.How much do you trust your provider to make medical decisions that are in your best interests?
12.How well did your provider listen to your needs?
13.How well did your provider answer your questions?
14.How well did your provider explain your treatment options?
15.How well did your provider explain your follow-up care?
16.How satisfied or dissatisfied were you with the amount of time your provider spent with you addressing your needs?
17.Is there anything we could have done to improve your last visit?