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One Minute Satisfaction Survey Please circle the name of the physician or ancillary service area you saw today. Dr. Briggs

Dr. Gibbs Dr. Loudermilk

Dr. Thomas

Dr. Scoresby

Dr. Peña

Allergy

Audiology

CT

N/A

Poor

Fair

Very Good Good Excellent

1. How long you waited to get an appointment

2. Courtesy and competency of the scheduler

3. Convenience of the office location

4. Getting through to the office by phone

5. Length of time waiting at the office

6. Courtesy and competency of front desk staff

7. Courtesy and competency of the nursing staff

8. Time spent with the person you saw

9. Explanation of what was done for you

10. Technical skills (thoroughness, carefulness,

12. Courtesy and competency of check out staff

13. The visit overall

14. Previous dealing with billing/collection staff

15. In general, would you say your health is

competence) of the person you saw 11. The personal manner (courtesy, respect, sensitivity, friendliness) of the person you saw

Definitely not

16. Would you recommend the person you saw to your family or friends

Comments:

Thank you for your time.

Probably not

Probably yes

Definitely yes

one-minute-satisfaction-survey