Office and
Staff: Yes/No
When Scheduling an appointment or obtaining
information is your wait time on the phone
reasonable?
Select
Yes
No
Once you are at the office is the amount of
time you wait to see the physician
reasonable?
Select
Yes
No
Is the parking at your physician's office
adequate?
Select
Yes
No
Are the hours
convenient?
Select
Yes
No
Is your physician's office staff
courteous?
Select
Yes
No
Are they helpful in scheduling referrals,
testing,
etc?
Select
Yes
No
Are you satisfied with the billing/payment
services at your physician's
office?
Select
Yes
No
Is your monthly statement
understandable?
Select
Yes
No
Your Physician:
Is the length of time your physician spends
with you
satisfactory?
Select
Yes
No
Does your physician take time to explain your
condition/diagnosis, tests and treatment
procedures?
Select
Yes
No
Does your physician listen to your concerns?
Select
Yes
No
Do you feel comfortable asking questions
related to your care or
treatment?
Select
Yes
No
