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Patient Satisfaction Survey
It is our goal to provide you with the best possible medical care. To do that, it
is important that we know your thoughts about the care you are receiving. We need
to know what were are doing right and in what area we need to improve. Your comments
will be kept strictly confidential. In advance, we want to thank you for your help.
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Which physician did you see?
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Did you see the Physician Assistant?
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What office were you seen?
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Why did you decide to seek medical treatment at this office?
When you called to schedule an appointment:
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Satisfied
 Very Dissatisfied
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The person who answered your call was courteous and helpful
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It was easy to schedule your appointment
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You were pleased with how you were treated when you arrived for your
appointment
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You received adequate assistance from the staff when filling out paperwork
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The medical staff was friendly and helpful
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The office staff was friendly and helpful
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You were satisfied with the amount of time the doctor spent with you
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The doctor explained your illness and treatment
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Your medical treatment was satisfactory
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Do you believe the fees were appropriate for the service rendered?
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Do you wish to be contacted about any concerns or questions you have?
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Thank you for completing the survey. Always feel free to contact our office if you
have any questions or concerns.
Drs. Ellis, Petrik, Schaper, Smith, Popham, and Nawab.
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