Patient Feedback Survey We value your feedback. Please take a moment to share your experience with us. Step 1 of 4 25% Feedback on Scheduling and AppointmentsHow easy was it to schedule your appointment with us?(Required) Very Easy Easy Neutral Difficult Very Difficult Were you able to make an appointment at a time that was convenient for you?(Required) Yes No How would you rate the courtesy of the staff member who scheduled your appointment? (1 = Poor, 5 = Excellent)(Required) 1 2 3 4 5 Did you receive a timely reminder for your appointment?(Required) Yes No Feedback on Your Arrival and the Waiting RoomUpon arrival, how long did you wait before being checked in?(Required) Less than 5 minutes 5-15 minutes 15-30 minutes More than 30 minutes Was the front-desk staff welcoming and helpful upon your arrival?(Required) Yes No If you had questions for the front-desk staff, were they answered to your satisfaction?(Required) Yes No Not Applicable Feedback on Your Healthcare Provider (Physician, Nurse, Specialist)How would you rate the amount of time your provider spent with you?(Required) Excellent Good Fair Poor Did your provider listen carefully to your health concerns?(Required) Yes No Did your provider explain things in a way that was easy to understand?(Required) Yes No Did you feel comfortable asking the nursing staff questions?(Required) Yes No Were you involved in decisions about your treatment and care plan?(Required) Yes No Feedback on Diagnosis and Treatment CommunicationClarity in communication is paramount for patient trust and a positive experience.Did your provider clearly explain your diagnosis or condition?(Required) Yes No Were the benefits and risks of your treatment options explained to you?(Required) Yes No Did you receive clear instructions regarding your medications?(Required) Yes No Not Applicable Were you informed about the next steps in your care plan?(Required) Yes No Other Comments
