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Patient Satisfaction Survey (Medical Group)
Were our fees / financial / insurance policies clearly explained to you?
Yes
No
Date of visit
With whom did you have your visit?
First
Last
Which office did you visit?
Ballantyne
Huntersville
Matthews
Monroe
Mooresville
Randolph Road
SouthPark
When you called for your appointment, was your call handled in a timely and professional manner?
Yes
No
Were you given an appointment in a timely manner?
Yes
No
When checking in, did the receptionist acknowledge you in a timely and friendly manner?
Yes
No
Upon checking out, did the receptionist acknowledge you in a timely and friendly manner?
Yes
No
Upon checking out, did the cashier acknowledge you in a friendly manner and answer any questions you had?
Yes
No
Were our fees / financial / insurance policies clearly explained to you?
Yes
No
During your visit did the doctor listen to and answer your questions clearly?
Yes
No
How long did you wait in our reception room?
0-15 minutes
16-30 minutes
31-45 minutes
How long did you wait in our exam room?
0-15 minutes
16-30 minutes
31-45 minutes
If you called the office with a medical problem, did our clinical staff respond in a timely manner
1-2 hours
2-4 hours
end of day
Did you feel the doctor spent enough time with you during your visit?
Yes
No
Would you refer our office to family or friends?
Yes
No
How did you hear about our office?
Do you have any other suggestions or comments that may help us improve or expand the services we provide?