We would like to ask you about your experience regarding your last visit to our office. Thank you for helping us continue to improve the care we provide for our patients.

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* 1. Please select the provider for your visit.

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* 2. How did you hear about Dr. Lingo and the Neurological and Spine Institute?

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* 3. Overall, how satisfied were you with your last visit to our office?

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* 4. Overall, how would you rate the service you received at the reception area of our office?

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* 5. Did the time it took our office to schedule your appointment meet your expectations?

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* 6. How long did you have to wait between the time of your referral to our clinic and the date of your appointment?

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* 7. Did your appointment with your provider start early, late or on time?

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* 8. How well did your provider listen to your needs?

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* 9. How well did your provider explain your treatment options?

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* 10. How well did your provider explain your follow-up care?

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* 11. Overall, how would you rate the service you received from our medical assistant, Sandra?

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* 12. If you phoned the office during regular business hours (8:00 AM - 5:30 PM Mon - Fri) with a question or concern, did you receive a response the same day?

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* 13. If you phoned the office after regular business hours (5:30 PM - 8:00 AM Mon - Thurs, 5:30 PM Friday - 8:00 AM Monday) with a question or concern, did you receive a response as soon as you needed?

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* 14. Were imaging studies, blood tests, or specialist referrals prior to or after your appointment completed in a timely fashion?

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* 15. How long did it take to complete any imaging studies, blood tests, or specialist referrals?

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* 16. How likely is it that you would recommend your provider to a friend or family member?

Not at all likely
Extremely likely

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* 17. How satisfied are you with the cleanliness and appearance of our facility?

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* 18. Is there anything we could have done to improve your last visit?

T