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Facility Patient Satisfaction Survey
Satisfaction survey for Family Health Services
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* Indicates required question
Which Provider do you see at Family Health Services? (your doctor, therapist or dentists name)
Your answer
What location are you seen?
*
Hayes Avenue
Water Street
Norwalk
One of our school clinics
Scheduling an appointment is easy
Always
Usually
Sometimes
Never
N/A
Clear selection
My Calls are returned within 48 hours
Always
Usually
Sometimes
Never
N/A
Clear selection
Clinic locations are easy to find
Always
Usually
Sometimes
Never
N/A
Clear selection
Do Clinic hours meet your scheduling needs?
Always
Usually
Sometimes
Never
N/A
Clear selection
The wait time met or exceeded my expectations
Always
Usually
Sometimes
Never
N/A
Clear selection
If my provider was delayed, I was informed
Always
Usually
Sometimes
Never
N/A
Clear selection
Someone follows up with me about my test results
Always
Usually
Sometimes
Never
N/A
Clear selection
Reception Greets me in a friendly, helpful manner
Always
Usually
Sometimes
Never
N/A
Clear selection
Billing options are explained in a clear, helpful manner
Always
Usually
Sometimes
Never
N/A
Clear selection
Nursing or Dental Assisting staff treats me well during my visit
Always
Usually
Sometimes
Never
N/A
Clear selection
Nursing or dental assisting staff staff providers clear instructions and answers my questions during my visit
Always
Usually
Sometimes
Never
N/A
Clear selection
My Provider allows adequate time for my visit and listens to my concerns
Always
Usually
Sometimes
Never
N/A
Clear selection
My Provider addresses my concerns and providers good information and resources
Always
Usually
Sometimes
Never
N/A
Clear selection
My Provider makes me feel like a partner in my treatment plan
Always
Usually
Sometimes
Never
N/A
Clear selection
The Facility is neat and clean
Always
Usually
Sometimes
Never
N/A
Clear selection
What is your overall rating of Family Health Services
Below expectations
1
2
3
4
5
Excellent
Clear selection
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