Complete Treatment SurveyWhat was the purpose of your visit to our office/clinic?Did you have an appointment? Yes No3) How long did you have to wait before you were seen by a doctor?Select HereLess than 5 MinutesThird Choice5-10 Minutes11-20 Minutes21-30 MinutesMore than 30 MinutesPlease tell us how satisfied or dissatisfied you were with each of the following: How satisfied were you with the way you were treated by the staff at our office? Very Satisfied Somewhat Satisfied Undecided Somewhat Dissatisfied Very DissatisfiedHow satisfied were you with the way you were treated by the nurse? Very Satisfied Somewhat Satisfied Undecided Somewhat Dissatisfied Very DissatisfiedHow satisfied were you with the way you were treated by the doctor? Very Satisfied Somewhat Satisfied Undecided Somewhat Dissatisfied Very DissatisfiedHow satisfied were you with the amount of time the doctor spent with you? Very Satisfied Somewhat Satisfied Undecided Somewhat Dissatisfied Very DissatisfiedHow satisfied were you with the amount of time you had to wait before being seen by a doctor? Very Satisfied Somewhat Satisfied Undecided Somewhat Dissatisfied Very DissatisfiedHow satisfied were you with the way your questions were answered? Very Satisfied Somewhat Satisfied Undecided Somewhat Dissatisfied Very DissatisfiedHow would you rate the courtesy you were shown by staff at our office? Very Satisfied Somewhat Satisfied Undecided Somewhat Dissatisfied Very DissatisfiedPlease tell us how much you agree or disagree with the following statements:The staff were knowledgeable. Strongly Disagree Disagree Undecided Agree Strongly AgreeThe staff were friendly and courteous. Strongly Disagree Disagree Undecided Agree Strongly AgreeThe nurse was knowledgeable. Strongly Disagree Disagree Undecided Agree Strongly AgreeThe nurse was friendly and courteous. Strongly Disagree Disagree Undecided Agree Strongly AgreeThe doctor was knowledgeable. Strongly Disagree Disagree Undecided Agree Strongly AgreeThe doctor was friendly and courteous. Strongly Disagree Disagree Undecided Agree Strongly AgreeMy questions were answered fully. Strongly Disagree Disagree Undecided Agree Strongly AgreeI was given complete attention by the doctor. Strongly Disagree Disagree Undecided Agree Strongly AgreeMy visit to the office/clinic was a pleasant experience. Strongly Disagree Disagree Undecided Agree Strongly AgreeOverall, would you say your visit to our office was very positive, somewhat positive somewhat negative or very negative? Very Positive Somewhat Positive Undecided Somewhat Negative Very NegativeWhat, if anything, did you like most about your visit to our office?What, if anything, did you like least about your visit to our office?Please tell us what, if anything, we can do to make future visits to our office more pleasant for you.CommentsThis field is for validation purposes and should be left unchanged.Δ