Patient Satisfaction

We want to hear from you!

At The Urology Team your satisfaction with the services provided is our goal. If you have a compliment for the care you received or would like to compliment our employees please call, write or e-mail our office. On the same token, if you have a complaint or would like to make suggestions please feel free to contact our Director. We value your compliments, suggestions and concerns.

For your convenience we have provided an online survey.

WHEN DID YOU VISIT?

Doctor:

Type:

Visit Date:

CLINIC SERVICES

Please rate the care your received. (5=Extremely satisfied to 1=Extremely dissatisfied)

Ease of scheduling your appointment:

Length of time on hold to schedule appointment:

Schedulers are informative and knowledgeable:

Appointments are timely and convenient:

Check-in staff were friendly, helpful and sensitive:

Timeliness in being seen by your physician:

Surgical schedulers were competent and explained surgery process and responsibilities:

Check-out employee was courteous, friendly and helpful:

DIRECT PATIENT CARE

Physician helped you understand your medical condition:

Do you trust you physician to make decisions/recommendations that are in your best interest?:

Nursing and clinical staff was competent, helpful and explained procedures:

Overall satisfaction:

Physician listened to you and answered your questions:

Treatments and instructions were explained before being performed:

How can we improve our services?:

Suggestions for physician improvement:

Was there any member of our staff who you feel should be recognized for friendliness, professionalism and helpfulness? If so, pl:

Patient Satisfaction

We want to hear from you!

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