GIM Patient Satisfaction Survey Question Title * 1. Which provider did you see? Steven Turner, MD Jeffrey J. Breiner, MD Karen K. Mayer, MD James J. McCann, PA-C Julie B. Queen, PA-C Amy McAlister, FNP Angela A. Keene, FNP Margery "Scottie" Springer, PA-C Emily Sudweeks, FNP OK Question Title * 2. What is your age? 14 - 17 years old 18 - 39 years old 40 - 64 years old over 64 years old OK Question Title * 3. In the past year, have you been without health insurance or unable to pay for doctor visits or prescriptions? Yes No OK Question Title * 4. Do you have any of the following conditions? (Choose all that apply) Diabetes Heart Disease Heart Failure High Blood Pressure Emphysema Asthma OK Question Title * 5. In the past 6 months, how many times have you been to the emergency room? None 1 or 2 times 3 or 4 times more than 4 times OK Question Title * 6. How many prescribed medicines do you take daily? None 1 to 2 3 to 6 7 to 9 more than 9 OK Question Title * 7. Do our office hours meet your needs? Yes No OK Question Title * 8. If our office hours do not meet your needs, what additional hours would meet your needs? Check all that apply. 5 p.m. to 7 p.m. Monday through Friday Saturday Sunday OK Question Title * 9. I am able to get an appointment for check ups (yearly exams, well visits, regular follow up visits) within a reasonable time frame. Poor Fair Good Very Good N/A Poor Fair Good Very Good N/A OK Question Title * 10. I am able to make a same-day appointment when sick or hurt. Poor Fair Good Very Good N/A Poor Fair Good Very Good N/A OK Question Title * 11. My phone calls are answered quickly. Poor Fair Good Very Good N/A Poor Fair Good Very Good N/A OK Question Title * 12. My phone calls are returned within a reasonable time frame based on urgency. Poor Fair Good Very Good N/A Poor Fair Good Very Good N/A OK Question Title * 13. I am able to get medical advice when the office is closed. Poor Fair Good Very Good N/A Poor Fair Good Very Good N/A OK Question Title * 14. If you rated us fair or poor on the above questions, please tell us about your experience. OK Question Title * 15. How long did you wait in the waiting room after your appointment time? 0 to 15 minutes 16 to 30 minutes 31 to 45 minutes more than 45 minutes OK Question Title * 16. In your opinion, the wait time in the waiting room was: Poor Fair Good Very Good Poor Fair Good Very Good OK Question Title * 17. How long did you wait in the exam room for your provider(s)? 0 to 15 minutes 16 to 30 minutes 31 to 45 minutes more than 45 minutes OK Question Title * 18. The office was clean and comfortable. Poor Fair Good Very Good Poor Fair Good Very Good OK Question Title * 19. The front desk staff were friendly and helpful. Poor Fair Good Very Good N/A Poor Fair Good Very Good N/A OK Question Title * 20. The front desk staff answered my questions. Poor Fair Good Very Good N/A Poor Fair Good Very Good N/A OK Question Title * 21. The clinical staff listened to me. Poor Fair Good Very Good N/A Poor Fair Good Very Good N/A OK Question Title * 22. The clinical staff were friendly and helpful. Poor Fair Good Very Good N/A Poor Fair Good Very Good N/A OK Question Title * 23. The clinical staff answered my questions. Poor Fair Good Very Good N/A Poor Fair Good Very Good N/A OK Question Title * 24. My provider listened to me. Poor Fair Good Very Good N/A Poor Fair Good Very Good N/A OK Question Title * 25. My provider spent enough time with me. Poor Fair Good Very Good N/A Poor Fair Good Very Good N/A OK Question Title * 26. My provider answered my questions. Poor Fair Good Very Good N/A Poor Fair Good Very Good N/A OK Question Title * 27. My provider was friendly and helpful. Poor Fair Good Very Good N/A Poor Fair Good Very Good N/A OK Question Title * 28. My provider gave me information that I can understand. Poor Fair Good Very Good N/A Poor Fair Good Very Good N/A OK Question Title * 29. My provider considered my personal or family beliefs. Poor Fair Good Very Good N/A Poor Fair Good Very Good N/A OK Question Title * 30. My provider involves other doctors or caregivers in my care when needed. Poor Fair Good Very Good N/A Poor Fair Good Very Good N/A OK Question Title * 31. My provider gives me good advice and treatment Poor Fair Good Very Good N/A Poor Fair Good Very Good N/A OK Question Title * 32. Have you ever been given information on what it means to have a medical home? Yes No OK Question Title * 33. Do you feel that Garner Internal Medicine is your medical home? Yes No OK Question Title * 34. If you needed other services that we do not provide, did we help you find the services you needed? Yes No OK Question Title * 35. If you have been referred to a specialist or community resource did you find them helpful? Yes No OK Question Title * 36. Would you recommend us to your family and friends? Yes No OK Question Title * 37. During your most recent visit to us, did someone talk to you about your health goals? Yes No OK Question Title * 38. During your most recent visit to us, were you asked today if you have seen any other healthcare providers since your last visit? Yes No OK Question Title * 39. During your most recent visit to us, were you helped with making an appointment to see specialty care providers? Yes No OK DONE