If you have any questions, please contact us at:
(404) 688-1350

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May 22, 2013

Patient Satisfaction Survey


We would like to know how you feel about the services we provide so we can make sure we are meeting your needs. Your responses are directly responsible for improving these services. All responses will be kept confidential and anonymous. Thank you for your time.



Your Age: Your Sex:
Your Race/Ethnicity:





Please check how well you think we are doing in the following areas: Great
5		 Good
4		 Ok
3		 Fair
2		 Poor
1
  Ease of Getting Care:
       Ability to get in to be seen   
       Hours Center is open   
       Convenience of Center's location   
       Prompt return on calls   
  Waiting:
       Time waiting room   
       Time in exame room   
       Waiting for tests to be peformed   
       Waiting for test results   
  Staff:
    Provider: (Physician, Dentist, Physician Assistant, Nurse Practitioner)
       Listens to you   
       Takes enough time with you   
       Explains what you want to know   
       Gives you good advice and treatment   
    Nurses and Medical Assistants:
       Friendly and helpful to you   
       Answers your questions   
    All Others:
       Friendly and helpful to you   
       Answers your questions   
  Payment:
       What you pay   
       Explanation of charges   
       Collection of payment/money   
  Facility:
       Neat and clean building   
       Ease of finding where to go   
       Comfort and Safety while waiting   
       Privacy   
  Confidentiality:
       Keeping my personal information private   
       The likelihood of referring your friends and relatives to us:   
  Do you consider this center your regular source of care?                                 

What do you like best about our center?

What do you like least about our Center?

Suggestions for improvement?

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