Anxiety Disorders | Developmental Disorders | Oyster Bay
     
 
 
Your opinion is very important to us. Please let us know how we did by completing the following online Patient Survey.
 
Date:
Name:
           
Are you a... New Patient           Returning Patient
           
Please indicate how much you agree with the following statements.
Strongly Agree= 5    Agree= 4      Neutral= 3     
Disagree= 2     Strongly Disagree= 1
           
1. It was easy to get an appointment:
 
5
4
3
2
1
2. You had an easy time getting through to our office by phone:
 
5
4
3
2
1
3. Your call was handled promptly and courteously:
 
5
4
3
2
1
4. Your calls were returned promptly:
 
5
4
3
2
1
5. The receptionist was friendly and helpful:
 
5
4
3
2
1
6. The reception area was clean and comfortable:
 
5
4
3
2
1
7. The length of time you waited in the reception area was  reasonable:
 
5
4
3
2
1
8. The nursing staff was friendly and knowledgeable:
 
5
4
3
2
1
9. The length of time you waited in the exam room was reasonable:
 
5
4
3
2
1
10. You felt comfortable talking with your physician:
 
5
4
3
2
1
11. You felt your physician listened to your concerns and answered your questions:
 
5
4
3
2
1
12. You were allowed adequate time with the physician:
 
5
4
3
2
1
13. Physician explanation of diagnosis, treatment and medicine was presented in an understandable manner:
 
5
4
3
2
1
14. You would recommend your physician to a friend:
 
5
4
3
2
1
15. You would recommend this practice to a friend:
 
5
4
3
2
1
16. You are pleased with the overall quality of care you received:
 
5
4
3
2
1
           
Please tell us which physician you saw today:
 
How did you hear about East Tennessee Brain and Spine?
 

           
Comments or Suggestions:
 
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