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Patient Satisfaction Survey
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Patient Satisfaction Survey
Patient Satisfaction Survey
drnovikovaadmin
2020-07-10T10:42:46+00:00
Patient Satisfaction Survey
1. Overall, how satisfied were you with your last visit to our office?
Extremely satisfied
Very satisfied
Somewhat satisfied
Not so satisfied
Not satisfied at all
2. How did you book your appointment?
Online
Phone
Email
3. How was your experience when booking an appointment with Dr Novikova?
Excellent
Very good
Good
Fair
Poor
4. Overall, how would you rate the service you received at the reception area of our office?
Excellent
Very good
Good
Fair
Poor
5. Did your appointment with your provider start early, late or on time?
10 or more minutes early
Less than 10 minutes early
On time
Less than 10 minutes late
10 or more minutes late
6. How well did your provider listen to your needs?
Extremely well
Very well
Somewhat well
Not so well
Not at all well
7. How well did your provider explain your treatment options?
Extremely well
Very well
Somewhat well
Not so well
Not at all well
No treatment was required
8. How well did your provider explain your follow-up care?
Extremely well
Very well
Somewhat well
Not so well
Not at all well
No follow-up care was required
9. How likely is it that you would recommend your provider to a friend or family member?
1
2
3
4
5
6
7
8
9
10
10. How satisfied are you with the cleanliness and appearance of our facility?
Extremely satisfied
Very satisfied
Somewhat satisfied
Not so satisfied
11. Is there anything we could have done to improve your last visit?
If you are human, leave this field blank.
Submit
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