Patient Satisfaction Survey

Patient Satisfaction Survey

We strive to deliver the highest quality foot care to you and your family. Please help us identify our areas of strengths and weaknesses so that we may continue to serve you better. Your answers are strictly confidential. Please answer only those questions that apply to you. You may either fill this survey out online or mail it back to us. Thank you for your time and valuable insight.


 

Please Rate Your Appointment

1. The length of time required between your call for an appointment and when scheduled to be seen:
ExcellentGoodFairPoor

2. The convenience of available appointments to your schedule:
ExcellentGoodFairPoor

3. The waiting time in our reception area prior to being seen:
ExcellentGoodFairPoor

4. The waiting time in the exam room prior to being seen by the doctor:
ExcellentGoodFairPoor

 

Please Rate Our Facility

1. The convenience of our office hours and location:
ExcellentGoodFairPoor

2. The cleanliness and comfort of the office itself:
ExcellentGoodFairPoor

3. Our parking facilities:
ExcellentGoodFairPoor

4. Availability of interesting reading material for you to read:
ExcellentGoodFairPoor

 

Please Rate Our Staff

1. The friendliness and courtesy of our receptionists:
ExcellentGoodFairPoor

2. The caring and courtesy of our assistants:
ExcellentGoodFairPoor

3. The helpfulness and courtesy of our business and insurance office personnel:
ExcellentGoodFairPoor

4. The helpfulness and courtesy of any facility that we referred you to (hospital, lab, MRI, etc.):
ExcellentGoodFairPoor

 

Please Rate Our Communication

1. Your ease in reaching our office by telephone:
ExcellentGoodFairPoor

2. Our timeliness in providing answers to your phone questions:
ExcellentGoodFairPoor

3. The quality of information that we provide by phone:
ExcellentGoodFairPoor

4. Describing tests and procedures to you prior to performing them:
ExcellentGoodFairPoor

5. Timely reporting of your test and procedures results:
ExcellentGoodFairPoor

 

Please Rate Your Visit

1. The attitude and conversation between our physician and you:
ExcellentGoodFairPoor

2. Discussion of diagnosis and treatment options so that you understood your choices:
ExcellentGoodFairPoor

3. The completeness of the examination in light of your stated medical problem:
ExcellentGoodFairPoor

4. The overall satisfaction with your physician:
ExcellentGoodFairPoor

 

Please Rate Your Overall Satisfaction

1. Your overall satisfaction with our practice:
ExcellentGoodFairPoor

 

Other comments:

Would you recommend this practice to a family member or friend?
YesNo