PATIENT SATISFACTION SURVEY Please take a moment to share your thoughts regarding your recent visit with us by filling out our survey online. Your confidential responses will assist us in improving our services and addressing areas where we can better meet your needs. Thank you for sharing your observations with us. Who Did You See Today:Month:Year:Your Age:Your Sex:How likely is it that you would recommend our services to a friend or relative?0 - Not at all likely12345678910 - Extremely likelyPlease rate how well you think we are doing in the following areas.EASE OF GETTING CARE: Ability to get in to be seenGreat - 5Good - 4OK - 3Fair - 2Poor - 1Hours Center is openGreat - 5Good - 4OK - 3Fair - 2Poor - 1Convenience of Center’s locationGreat - 5Good - 4OK - 3Fair - 2Poor - 1Prompt return on callsGreat - 5Good - 4OK - 3Fair - 2Poor - 1WAITING: Time in waiting roomGreat - 5Good - 4OK - 3Fair - 2Poor - 1Time in exam roomGreat - 5Good - 4OK - 3Fair - 2Poor - 1Waiting for tests to be performedGreat - 5Good - 4OK - 3Fair - 2Poor - 1Waiting for test resultsGreat - 5Good - 4OK - 3Fair - 2Poor - 1PROVIDER:Listens to youGreat - 5Good - 4OK - 3Fair - 2Poor - 1Takes enough time with youGreat - 5Good - 4OK - 3Fair - 2Poor - 1Explains what you want to knowGreat - 5Good - 4OK - 3Fair - 2Poor - 1Gives you good advice and treatmentGreat - 5Good - 4OK - 3Fair - 2Poor - 1MEDICAL/DENTAL ASSISTANTS:Friendly and helpful to youGreat - 5Good - 4OK - 3Fair - 2Poor - 1Answers your questionsGreat - 5Good - 4OK - 3Fair - 2Poor - 1ALL OTHER STAFF:Staff was friendly and helpful to youGreat - 5Good - 4OK - 3Fair - 2Poor - 1Staff answered your questionsGreat - 5Good - 4OK - 3Fair - 2Poor - 1PAYMENT:Value of services provided based on what you paidGreat - 5Good - 4OK - 3Fair - 2Poor - 1Explanation of chargesGreat - 5Good - 4OK - 3Fair - 2Poor - 1Collection of payment/co-pay (payment process)Great - 5Good - 4OK - 3Fair - 2Poor - 1FACILITY:Neat and clean buildingGreat - 5Good - 4OK - 3Fair - 2Poor - 1Ease of finding where to goGreat - 5Good - 4OK - 3Fair - 2Poor - 1Comfort and safety while waitingGreat - 5Good - 4OK - 3Fair - 2Poor - 1Privacy of the environmentGreat - 5Good - 4OK - 3Fair - 2Poor - 1LIKELY TO RECOMMEND:What do you like best about our Health Center?How can we make your experience at Nasson Health Care better?Name (optional) First Last Email (optional)