Appointment Information:

Date:

Location:

Appointment Scheduling
No Opinion
Poor
Fair
Good
Excellent
How was the efficiency of our phone system?





I received prompt and courteous service.





My appointment was scheduled within an acceptable time frame.





Front Office/ Reception Staff
No Opinion
Poor
Fair
Good
Excellent
Upon my arrival, I was greeted in a courteous and timely manner.





The registration process was quick and easy.





I waited an acceptable amount of time to see the provider.





Appearance of the Facility
No Opinion
Poor
Fair
Good
Excellent
The waiting room was clean with a pleasant decor.





The exam room was clean.





Clinical Staff
No Opinion
Poor
Fair
Good
Excellent
The nurse and clinical staff were courteous and professional.





The staff showed concerns for my problems.





Consideration was given to my privacy.





Provider: Physician, Physician Assistant, Nurse Practitioner
No Opinion
Poor
Fair
Good
Excellent
The provider clearly explained my problem, condition and/or procedure.





The provider showed respect for my questions.





The provider was professional and friendly.





Other Questions
No Opinion
Poor
Fair
Good
Excellent
How was our promptness in returning your calls?





How likely are you to recommend our services to others?





Does our website, www.prattmed.com, meet your needs?





Comments:
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