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Patient Satisfaction Survey

Please correct the field(s) marked in red below:

1
The time of day of my visit was:
 *
The time of day of my visit was:

2
Ease of getting care:
 *
Ease of getting care:
Great Good Okay Fair Poor
Ability to get in to be seen:
Hours the Center is open:
Phone system:

3
Reception:
 *
Reception:
Great Good Okay Fair Poor
Time in reception area:
Comfort level of reception area:

4
Staff - Reception:
 *
Staff - Reception:
Great Good Okay Fair Poor
Friendly and helpful:
Takes enough time with you:
Explains what you want to know:

5
Staff - Nurses and medical assistants:
 *
Staff - Nurses and medical assistants:
Great Good Okay Fair Poor
Friendly and helpful to you:
Provider (physician, physician assistant, nurse practitioner):

6
Staff - Pharmacy:
 *
Staff - Pharmacy:
Great Good Okay Fair Poor
Friendly and helpful to you:
Answers your questions:

7
Payment:
 *
Payment:
Great Good Okay Fair Poor
Copay:
Explanation of charges:

8
Facility:
 *
Facility:
Great Good Okay Fair Poor
Neat and clean building:
Parking:

9
Confidentiality:
 *
Confidentiality:
Great Good Okay Fair Poor
Keeping my personal information private:

10
The likelihood of referring your friends and relatives to us:
 *
The likelihood of referring your friends and relatives to us:
Great Good Okay Fair Poor
Suggesting PHC to your friends and relatives

11
What do you like best about our center?
12
What do you like least about our center?
13
Has our recent change to Electronic Medical Recordkeeping improved your visit?
Has our recent change to Electronic Medical Recordkeeping improved your visit?

Thank you for completing our survey!

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