Patient Satisfaction Survey

Dear Patient:

Providing quality care and meeting the needs of our patients is important to our office. We want to be confident that we are providing you with first class care along with special and personal attention.

To accomplish this, we need your input. Your concerns and suggestions are important to us, and we are asking you to take a few minutes to complete our Patient Satisfaction Survey. We encourage you to be open and honest in your assessment. Our practice maintains all doctor/patient information in the strictest of confidence, including this anonymous survey.

Thank you for taking the time to provide your feedback.

Sincerely,

The Physicians and Staff of Ophthalmology Associates and LASIK Center of Mankato

 

Please select your answers, using a scale of 1 to 5:

① ② ③ ④ ⑤
Poor Fair Average Good Excellent

 

PATIENT SATISFACTION SURVEY
1. When you called for an appointment, how would you rate the response from the person who answered the telephone?
2. When you arrived at the office, how would you rate the receptionist(s) in the following areas: Friendly, Helpful, and Courteous?
3. How acceptable was the amount of time spent in the reception area and exam room before seeing the doctor?
4. When you were called to the exam room, how would you rate our staff in the following areas: Friendly, Competent, and Professional?
5. During your examination, how would you rate the doctor in the following areas: Friendly, Competent, and Professional?
6. When you saw the doctor, how would you rate the amount of time he/she spent with you, answering your questions, and explaining your diagnosis and treatments to your satisfaction?
7. If treatment was recommended, how satisfied were you with the information provided by the doctor/staff regarding your treatment and follow-up care?
8. When asking payment questions, how would you rate our staff in the following areas: Friendly, Helpful, and Courteous?
9. Please rate your overall experience with our practice.
10. Please rate the likelihood that you would recommend our practice to your family and friends.