Waukesha, Oconomowoc, Ft. Atkinson, Watertown and Mukwonago WI
Location of your visit:
Waukesha Oconomowoc Watertown Fort Atkinson Mukwonago
Name of Physician your visit was with?
Would you like us to contact you regarding your visit? Yes No
If yes, please give us your name and phone number
Response definition: P = poor F = fair G = good VG = very good E = excellent
1. Ease of scheduling appointments:
P F G VG E
2. Friendliness of appointment scheduler:
3. Convenience of our clinic hours:
4. Availability of parking:
5. Timeliness of registration process:
6. Courtesy shown by reception staff:
7. Satisfaction with length of time between registration and exam:
8. Explanation of any prolonged wait, if applicable:
9. Friendliness and concern of your care provider (assistant, dr):
10. Opportunity to discuss your concerns with the doctor:
11. Was your medical condition and treatment explained thoroughly?
12. Were you able to understand explanation and instructions?
13. Were you able to understand the financial information?
Comments?
Suggestions?
