The Centers Patient Satisfaction Survey (2022)
Please tell us how you feel about The Centers for Reproductive Health. Your responses help us make improvements and your answers are anonymous.
Thank you!
*
1.
What OCO Center of Reproductive Health are you completing this survey for?
(Required.)
Oswego
Fulton
Mexico
SUNY Oswego
*
2.
How long have you been a patient of OCO's Centers for Reproductive Health?
(Required.)
Less than 1 month
1 - 6 Months
7 - 12 Months
1 - 2 Years
3 - 4 Years
5+ years
*
3.
What is your age?
(Required.)
Under 19
19-24
25-50
51-64
65+
*
4.
Are you:
(Required.)
Male
Female
Transgender M-F
Transgender F-M
Other
Prefer Not to Disclose
*
5.
From the day you made your appointment, how many days passed before you were seen?
(Required.)
0/Same Day
1 - 3 Days
4 - 6 Days
7+ Days
*
6.
Did you feel staff were helpful when you called to schedule your appointment?
(Required.)
Yes
No
*
7.
How easy is it to attend your appointments?
(Required.)
Easy
Somewhat easy
Somewhat difficult
Difficult
Please explain your answer above:
*
8.
Are you satisfied with the check-in process?
(Required.)
Yes
No
Why or why not?
*
9.
Typically, how long do you wait in the waiting room when you come in for an appointment?
(Required.)
Extremely long
Very long
Somewhat long
Not so long
Not at all long
*
10.
Were you satisfied with your nurse?
(Required.)
Yes
No
Why or why not?
*
11.
Were you satisfied with your provider?
(Required.)
Yes
No
Why or why not?
*
12.
Overall, how helpful were staff during your visit?
(Required.)
Very helpful
Helpful
Not Helpful
Please explain your answer:
*
13.
How satisfied are you with The Centers?
(Required.)
Very satisfied
Satisfied
Somewhat dissatisfied
Very dissatisfied
Please share why you were or were not satisfied:
*
14.
Do you feel you were treated respectfully?
(Required.)
Yes
No
Why or why not?
*
15.
Did The Centers meet your needs?
(Required.)
Yes
Most needs met
Few needs met
No
Please explain your answer:
*
16.
What services are most helpful to you (check all that apply)?
(Required.)
Birth Control
Annual Exams
STD Testing/Treatment
Addressing Problems
Cancer Screenings
Other (please explain):
17.
Please share any other comments:
