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Satisfaction Survey

Please indicate your level of satisfaction with each of the factors listed below based on your experience,, where "5" is "extremely satisfied" and "1" means "very dissatisfied."

Telephone staff promptness, consideration, and courteousness 

1 2 3 4 5

Appointment scheduled in a timely manner

1 2 3 4 5

Receptionist promptness, consideration, and courteousness upon arrival

1 2 3 4 5

Comfort and cleanliness of the reception area and exam rooms

1 2 3 4 5

The amount of time spent waiting to see Dr. Joseph

1 2 3 4 5

Knowledge and skill level of medical assistants

1 2 3 4 5

Brochures and amount of education provided

1 2 3 4 5

Information regarding insurance benefits and billing procedures

1 2 3 4 5

Skills and competence of Dr. Joseph

1 2 3 4 5

Amount of time Dr. Joseph spent with you concerning your problem and discussing a treatment plan

1 2 3 4 5

Dr. Joseph's willingness to explore treatment alternatives with you

1 2 3 4 5

Dr. Joseph's attempts to provide solutions that meet your healthcare goals

1 2 3 4 5

Your understanding of your diagnosis and treatment plan

1 2 3 4 5

Patient Information

Age of patient 

Gender of patient 

Male Female

Patient's insurance plan type

PPO/HMO Commercial Medicare Worker's Comp Other

Would you like to speak with our office manager to discuss any of these issues ?

Yes No

Please specifically identify any other areas of concern as they relate to the quality of care you have received.  Any comments (positive or negative) will help us serve you better!