Were you able to schedule an appointment that was convenient for you? If no, please explain.

Was the receptionist friendly and attentive?

Does your doctor seem interested in you as a person?

Does your technician seem interested in you as a person?

How long after your scheduled appointment did you wait before being seen?

During your visit, do you believe you were given an adequate explanation of your illness or medical condition, medications, and other treatment recommendations? If no, how could we have improved?

Were your questions answered adequately? If no, how could we have improved?

Please rate the appearance of the facility
Excellent
Good
Fair
Poor

How well do you like our practice's hours?

How did you first hear about our practice?

Overall, how would you consider your experience with us?
Excellent
Good
Fair
Poor

Would you recommend our practice to friends and family? If no, please explain.

Please leave your name and phone number if you require a phone call to discuss this matter.