Please tell us how we are doing in meeting your care needs. Your answers will help us see what areas we need to work on. All responses are confidential. Thank you for your time.

You are:

Today you saw:

Your age:

Your insurance:

Please let us know how well you think we are doing in the following areas:

Ability to get an appointment:

Hours the clinic is open:

Timely response to phone calls and/or patient portal questions:

Time spent in the waiting room:

Time in exam room before being seen by the doctor:

You are listened to and treated with respect:

You get answers to your questions and concerns:

Your.doctor explains things in a way you can understand:

Gives you good advice and treatment:

Staff keeps you informed about tests and referrals:

How well staff worked together to provide care:

You are included in decisions about your care:

The provider works with you to help you make healthy choices:

Overall satisfaction with the clinic staff and the care they provide:

What can we do to improve your care?