GMHC Farmington Patient Satisfaction Survey Question Title * 1. Which one of our departments did you recently visit at our Farmington location? Farmington Medical Farmington Dental Question Title * 2. Were you asked if you had visits with other healthcare providerssince your last visit with us? Yes No Question Title * 3. How would you rate your ease of getting care/making appointments? Excellent Good Fair Poor Question Title * 4. How would you rate your ability to get medical/dental advice when the office is closed? Excellent Good Fair Poor Question Title * 5. How would you rate your satisfaction with your provider/staff? Excellent Good Fair Poor Question Title * 6. How would you rate your provider on getting you answers and/or making you feel respected? Excellent Good Fair Poor If you would like to give a "shout out" to a specific employee please leave their name in the comment box so they can be recognized. Question Title * 7. You may need other services that we do not provide. How would you rate the help/contact information you received from our staff for these services? Excellent Good Fair Poor Question Title * 8. How are our costs, collections, and explanation of benefits in comparison to other local healthcare providers providing similar services? Excellent Good Fair Poor Question Title * 9. Will you return to GMHC for care? Yes No Question Title * 10. Will you recommend GMHC to friends/family? Yes No Question Title * 11. Overall, was the facility clean? Yes No Other (please specify) Question Title * 12. Are you currently aware of our sliding scale discount? Yes No Question Title * 13. If you answered yes to the last question, Which Federal Poverty Level percentage do you fall within: 0-100% 101-133% 134-167% 168-200% N/A, I answered no to the last question. Question Title * 14. How long was your wait time in the waiting room? Long (greater than 10 minutes) Average (5-10 minutes) Short (Less than 5 minutes) Question Title * 15. How long was your wait time in the exam room? Long (greater than 10 minutes) Average (5-10 minutes) Short (less than 5 minutes) Question Title * 16. Do you currently have transportation? Yes No, I am not interested in transportation resources. No, I AM interested in transportation resources. (Please call us at 573-438-9355 for further information) Question Title * 17. Great Mines offers same-day appointments at 12:30pm each day. Does this time work for your same-day needs? Yes, this meets my needs No, I prefer mornings same-day Other (please specify) Question Title * 18. Please provide any suggestions or additional feedback. Question Title * 19. To be entered into our drawing for the survey drawing please provide your name and contact information. (Optional) Submit