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Patient Satisfaction Survey

Dear Patient,

Thank you for visiting us. We appreciate you taking time out of your schedule to complete this quick 5-10 minute survey. This will help us to provide better care in future.

Gender?

Age?

Race / Ethnicity?

50

How would you rate the speed of care given?

Excellent
Good
Fair
Poor
Time in waiting room
Time in exam room
Waiting for tests to be performed
Waiting for test results

How would you rate the ease of getting care?

Excellent
Good
Fair
Poor
Ability to get in to be seen make an appointment
Hours center (hospital) is open
Convenience of Office Locations
Prompt return of calls

Which physician were you seen by?

How would you rate your Physician, Nurse, Other medical staff

Excellent
Good
Fair
Poor
Listens to you and takes enough time with you
Explains what you want to know
Gives you good advice and treatment
Friendly and helpful to you
Efficient and Professional

How would you rate all other staff (support, tech, etc.) attitude?

Excellent
Good
Fair
Poor
Friendly and helpful to you
Answers your questions
Efficient and Professional

How would you rate your feeling about the facilities?

Excellent
Good
Fair
Poor
Neat and clean
Ease of finding where to go
Comfort and Safety
Privacy

How would you rate the cost of our services?

How would you rate our billing?

Excellent
Good
Fair
Poor
Explanation of charges
Collection of payments

Would you recommend us to your friends or relatives?

What do you like / dislike about Waccamaw Dermatology?

500

What can we do better?

500

Thank you for completing this survey.

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