Patient Satisfaction Survey

Patient Satisfaction Survey

This survey is designed to get feedback from the patient about their office visit.

1.) How did you hear about Expedite Walk-in Clinic?

Website Yellow Pages Advertisement Word of Mouth Referral Other

2.) About how long did you wait before being brought back to the exam room?

3.)Upon your arrival, how would you rate the receptionist who registered you?

Poor

Acceptable

Good

Excellent

4.) Was the reception area clean and inviting?

Yes No

5.) How would you rate the medical assistant who brought you back to the room?

Poor Acceptable Good Excellent

6.) Was the exam room was clean and comfortable?

Yes No

7.) How would you rate your medical examination with the Nurse Practitioner or Physician Assistant who provided your care?

Poor Acceptable Good Excellent

8.) Was your visit completed in a timely manner?

Yes No

9.) Our continuing goal is to provide an atmosphere of compassion, devotion, and respect to all who walk through our doors. Overall, how would you rate the level of care and attention that was provided to you?

Poor Acceptable Good Excellent

10.) How would you rate your overall experience with the Expedite Walk-in Clinic?

Poor Acceptable Good Excellent