Thank you for taking the time to complete this survey. Please answer the following questions to the best of your ability.

Please enter your responses below:

  1. Courtesy and helpfulness of the staff who answer the phone?

  2. Ease of seeing your preferred provider?

  3. Friendliness of the staff?

  4. Efforts of the staff to always explain any delays?

  5. Teamwork displayed between receptionist and clinic's medical and nursing personnel?

  6. The time you spent in the exam room before the provider came in

  7. The staff washed his or her hands or used waterless sanitizer when he or she entered and exited your room?

  8. Time the physicians and medical providers spent with you?

  9. Assistance offered to help you schedule follow-up care?

  10. General cleanliness of the building?

  11. Efforts made by the staff to ensure your privacy?

  12. Would you recommend this clinic to your friends and family

  13. If there is one thing you would suggest that we work on immediately to create a better experience for our patients, what would it be?

  14. Other comments