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Patient Satisfaction Survey

The entire team of Doctors Immediate Care would like to thank you for giving us a chance to be of service to you. We hope that we exceeded your expectations.

Please fill out the brief survey below to help us exceed “your” the patient’s expectations.

It will help our management to further improvise our services and make sure we continue to meet your standards. When you are finished, please click the SUBMIT SURVEY button at the bottom.

INSTRUCTIONS:Please rate the services you received from our practice. Check the appropriate circle that best describes your experience. If a question does not apply to you, please skip to the next question. Space is provided for you to comment on good or bad things that may have happened to you. The following questions pertain to visits to your physician’s office only; this survey does not include visits to hospitals or other locations.

1. Did the front desk invite you in a polite manner?  Yes No
2. Did the doctor greet you in a courteous manner?  Yes No
3. How would you rate the waiting time at our center?  Very Good Good Fair Poor Very Poor
4. How would you rate the ability of our medical assistants in performing their duties?  Very Good Good Fair Poor Very Poor
5. How would you rate the competence of our doctors in performing their duties?  Very Good Good Fair Poor Very Poor
6. Would you be interested to share the services of Doctors Immediate care with others?  Yes No
7. How would you rate the services of our staff (Physician, Dentist, Nurse Practitioner)?  Very Good Good Fair Poor Very Poor
8. Were the nurses and medical assistants friendly and helpful to you? Were you content?  Yes No
9. Was the payment process well-structured and easy to follow?  Yes No
10. Can you provide some valuable suggestions to improve our overall services?
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