Patient Satisfaction Survey Physician / Provider*Please choose...Dr. CranorDr. KauffmanDr. SamuelsonKatha MaguireCarrie ReynoldsSamantha SteelmanHolly GustafsonPlease rate how satisfied you are with the following aspects of making your appointment:Courtesy of the person who scheduled your appointment*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowNumber of days you waited between your call and your appointment*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowGetting an appointment time convenient for you*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowGot to see your preferred doctor*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowPlease rate how satisfied you are with the following aspects of your office visit:The courtesy of the receptionist*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowThe comfort and condition of the waiting area*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowThe amount of time you waited in the reception area before going to an exam room*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowThe courtesy of the nurse who prepared you for your visit*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowThe care provided by our nursing staff*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowPlease rate how satisfied you are with your care provider:The amount of time you waited in the exam room for the physician / provider to arrive*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowThe respect and concern shown by your physician / provider*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowHow well your physician/provider listened when you explained your medical needs and concerns*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowHow well your physician/provider explained your care and treatment*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowHow well your physician/provider explained your medications (if any)*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowInstructions your physician/provider gave you about follow-up care*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowThe thoroughness and completeness of your exam and medical treatment*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowThe amount of time your physician/provider spent with you*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowHow well your physician/provider involved you in decisions about your care*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowPlease rate your satisfaction with these final issues:The privacy of the environment including the protection of your confidential information*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowExplanations about costs and paying for your care*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowHelp with your insurance questions*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowPlease rate your overall satisfaction:Overall, how satisfied were you with the quality of care and services you received from our medical practice?*Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedDo not knowRecommendation:Would you recommend our practice to your friends and family should they need medical care?*Definitely WouldProbably WouldProbably Would NotDefinitely Would NotDo not knowHow many times have you visited our practice in the past 12 months?*Please chooseOne - First VisitTwoThreeFourFiveSix or moreWhat is your age?*Please chooseUnder 2020-2930-3940-4950-5960-6970-7980 or overGender*MaleFemaleHow could we have improved your visit to our medical practice?NameThis field is for validation purposes and should be left unchanged.