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PATIENT SATISFACTION SURVEY

Dear Patient,

Thank you for choosing Lapeer Urgent & Family Care.  We appreciate the opportunity to serve you. We hope that we exceeded your expectations for excellent care.

So that we may better meet our patients' needs, we would like to know more about your visit with us. Please take a moment to tell us about your experience in this survey.

Thank You!

The Doctors & Staff
of Lapeer Family & Urgent Care
 
MAKING THE APPOINTMENT
 
When was your last appointment?
 
 
Who was your appointment with? View Photos
 
    Y   N    Was this your first visit?     
    Y  N       Were you able to schedule appointments soon enough to meet your medical needs?     
    Y   N      If you requested your appointment by telephone, were you treated courteously by our staff during the call?     
    Y   N      If you contacted our staff to ask medical questions that did not require a visit, did you receive satisfactory information in response?     
      
OFFICE VISIT
Was this visit:  A Walk-In    Scheduled Appointment
    Y   N        Once you were at the office, were you able to see a member of our clinical staff in a reasonable amount of time?     
    Y   N          Did you feel free to ask our clinical staff any and all questions about your health and treatment?     
    Y   N       Were all your questions about your medical problems and treatment satisfactorily answered?     
    Y  N       Based on your experience with us, would you recommend us to your friends?     
       
If you had to wait beyond your scheduled appointment time, how long did you have to wait?
 
Please rate the following aspects of your office visit:
    Very
Good  
 		 Good  Fair  Poor 
a) Quality of Care Provided:  
b) Courtesy of Receptionists:  
c) Courtesy of Clinical Staff:  
d) Courtesy of Physician:  
e) General Appearance of
Office or Waiting Area:		  
 
ADMINISTRATIVE
 
    Y   N      Are you satisfied with the insurance and billing procedures at our office?     
    Y   N            If you had a question about your insurance or bill, were you able to get sufficient information or a satisfactory answer from someone in our office?     
       
COMMENTS

 
  What did you like most about your visit?
  What did you like least about your visit?
  Do you have any suggestions or additional comments that would help us to better serve you and our other patients? If so, please enter your comments in the text box below. We appreciate your input.

 

  Do you have any suggestions on how we can improve our Web site?

 

CONTACT INFO
 
If you would like us to contact you concerning your comments,
please fill out the information below:
   
   Name:  
   E-mail:  
   Phone: