Your Input is Valuable

  1. What location was your last appointment at?
  2. Is the office able to schedule an appointment when you want or need one?
  3. Did this office tell you what to do for care on evenings, weekends and holidays?
  4. In the last twelve months, if you needed care , were you able to get help from this office over the weekends, evenings or holidays?
  5. Did you get answers to medical questions on the same day you phoned?
  6. Did you see the provider within 15 minutes of your appointment time?
  7. Have you participated in a Telehealth visit with us?
    Please tell us about your experience:
    0/750
  8. Did the provider explain things in a way that was easy to understand?
  9. Have you been referred to a specialist in the last 12 months?
  10. Did your provider seem to have up to date information about your visit with the specialist?
  11. Did the provider respect what you had to say?
  12. In the last 12 months did your provider talk to you about health goals?
  13. Did your provider's office follow-up to give you results of a blood test, x-ray, or other test?
  14. In the last 12 months did anyone ask you if there were things that make it hard to take care of yourself?
  15. Did the provider talk to you about the reasons to take medication?
  16. In the last 12 months, did anyone talk about a personal problem, family problem, alcohol or drug use or a mental or emotional illness?
  17. In the last 12 months, has anyone talked to you about worry and stress in your life?
  18. What is one thing you wish your provider would do differently?
    0/750
  19. Additional comments
    0/750
  20. If you were to refer us to someone else, what would you say to them?
    0/750