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* 1. Which doctor did you see for your procedure ?

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* 2. Did you visit our website prior to your procedure ?

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* 3. My pre-procedure instructions were clear and the written materials were clear.

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* 4. The person that scheduled my procedure was courteous and helpful.

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* 5. The office was easy to find.

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* 6. The front desk staff was courteous and helpful.

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* 7. My financial interactions with the practice were conducted in a satisfactory manner.

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* 8. The wait time on the day of procedure was acceptable.

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* 9. The nurse or medical assistant that checked me in and started my IV was understanding and caring.

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* 10. The physician was understanding, patient and caring.

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* 11. The nurse or medical assistant that took care of me after my procedure was understanding, patient and caring.

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* 12. The instructions I received before leaving the faclility were clear.

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* 13. I received adequate sedation during my procedure.

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* 14. The facility was clean and comfortable.

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* 15. Would you recommend our services without hesitation.

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* 16. How can we improve our care and facility ?

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