Patient Satisfaction Survey
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.
1.
Please select the provider for your visit.
P. Ryan Lingo, MD
Elizabeth Hinely, AGACNP
2.
How did you hear about Dr. Lingo and the Neurological and Spine Institute?
Primary care provider or other referring specialist
A current or former patient of the practice
Magazine or billboard advertisement
Television commercial
Facebook
www.neurologicalinstitute.com
Other (please specify)
3.
Overall, how satisfied were you with your last visit to our office?
Extremely satisfied
Very satisfied
Somewhat satisfied
Not so satisfied
Not satisfied at all
4.
Overall, how would you rate the service you received at the reception area of our office?
Excellent
Very good
Good
Fair
Poor
5.
Did the time it took our office to schedule your appointment meet your expectations?
Exceeded expectations
Met expectations
Below expectations
6.
How long did you have to wait between the time of your referral to our clinic and the date of your appointment?
0 to 2 days
3 to 7 days
1 week to 1 month
Greater than 1 month
7.
Did your appointment with your provider start early, late or on time?
15 or more minutes early
Less than 15 minutes early
On time
Less than 15 minutes late
15 or more minutes late
8.
How well did your provider listen to your needs?
Extremely well
Very well
Somewhat well
Not so well
Not at all well
9.
How well did your provider explain your treatment options?
Extremely well
Very well
Somewhat well
Not so well
Not at all well
No treatment was required
10.
How well did your provider explain your follow-up care?
Extremely well
Very well
Somewhat well
Not so well
Not at all well
No follow-up care was required
11.
Overall, how would you rate the service you received from our medical assistant, Sandra?
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
I did not interact with Sandra
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?
Yes
No
I did not phone the office with a question or concern
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?
Yes
No
I did not phone the office with a question or concern
14.
Were imaging studies, blood tests, or specialist referrals prior to or after your appointment completed in a timely fashion?
Yes
No
No imaging studies, blood tests, or referrals were made during my appointment
Please list which studies or referrals were ordered by your provider below (i.e. x-ray, CT, MRI, blood test, EMG/nerve conduction study, specialist referral)
15.
How long did it take to complete any imaging studies, blood tests, or specialist referrals?
Same day as appointment
Within 1 week
Within 1 month
Greater than 1 month
16.
On a scale of 0 to 10,
How likely is it that you would recommend your provider to a friend or family member?
0 for Not at all likely, 10 for Extremely likely
Not at all likely
Extremely likely
0
1
2
3
4
5
6
7
8
9
10
17.
How satisfied are you with the cleanliness and appearance of our facility?
Extremely satisfied
Very satisfied
Somewhat satisfied
Not so satisfied
Not satisfied at all
18.
Is there anything we could have done to improve your last visit?
