Patient Satisfaction Survey Question Title * 1. How likely is it that you would recommend your doctor to a friend or family member? NOT AT ALL LIKELY EXTREMELY LIKELY 0 1 2 3 4 5 6 7 8 9 10 0 1 2 3 4 5 6 7 8 9 10 OK Question Title * 2. Overall, how would you rate the service you received from the staff at the clinics of Drs. Smoker ? Excellent Very good Good Fair Poor OK Question Title * 3. How easy or difficult was it to schedule your appointment at a time that was convenient for you? Very easy Easy Neither easy nor difficult Difficult Very difficult OK Question Title * 4. How easy is it to schedule urgent appointments with your doctor when you're ill? Extremely easy Very easy Somewhat easy Not so easy Not at all easy OK Question Title * 5. How comfortable was the lobby and waiting area? Extremely comfortable Very comfortable Somewhat comfortable Not so comfortable Not at all comfortable OK Question Title * 6. How friendly is your doctor's office staff? Extremely friendly Very friendly Somewhat friendly Not so friendly Not at all friendly OK Question Title * 7. Did your appointment with your provider start early, late or on time? Very early Early On time Late Very late OK Question Title * 8. Overall, how would you rate the service you received from the staff at our office? Excellent Very good Good Fair Poor OK Question Title * 9. During your most recent visit, did your healthcare provider listen carefully to you? Yes, definitely Yes, somewhat No OK Question Title * 10. How well did your provider answer your questions? Extremely well Very well Somewhat well Not so well Not at all well OK Question Title * 11. How satisfied or dissatisfied were you with the amount of time your provider spent with you addressing your needs? Very satisfied Satisfied Neither satisfied nor dissatisfied Dissatisfied Very dissatisfied OK Question Title * 12. Overall, how would you rate the care you received from your provider? Excellent Very good Good Fair Poor OK Question Title * 13. At which of our clinics do you normally receive your care? OK Question Title * 14. Who is your primary care provider? OK Question Title * 15. Please share any other comments you have below: OK DONE