Patient Satisfaction Report Card Help us provide you with the best possible care by responding to this short survey. Which doctor did you see? How did you hear about us? (Check all that apply) NewspaperPhone BookAdvertisementInternet SiteInsurance DirectoryDoctor ReferralFriend/RelativeOther If you were referred by another doctor, what is the name of that doctor? Please rate your level of satisfaction in the following areas: The doctor's explanation of your medical problem Very satisfiedNeither satisfied nor dissatisfiedNot at all satisfied The amount of time the doctor spent with you Very satisfiedNeither satisfied nor dissatisfiedNot at all satisfied The doctor's level of concern for you and your problem Very satisfiedNeither satisfied nor dissatisfiedNot at all satisfied The ease of making an appointment Very satisfiedNeither satisfied nor dissatisfiedNot at all satisfied The friendliness and courtesy shown by the front office staff Very satisfiedNeither satisfied nor dissatisfiedNot at all satisfied The length of time waiting to be seen Very satisfiedNeither satisfied nor dissatisfiedNot at all satisfied The ease of scheduling your surgery in the office Very satisfiedNeither satisfied nor dissatisfiedNot at all satisfied The level of professionalism in handling phone calls Very satisfiedNeither satisfied nor dissatisfiedNot at all satisfied The overall care provided to you Very satisfiedNeither satisfied nor dissatisfiedNot at all satisfied How likely would you be to recommend Surgical Associates of West Florida to a friend? Very likelyNo opinionNot at all likely How can we improve our services in the future? What is your age? < 1818–6566 or older Sex MaleFemale
