Your browser does not support JavaScript!
This form cannot automatically check that you have submitted all of the required fields without JavaScript.
Please be sure to submit all required fields (marked with stars).

Mitchell County Hospital

Family Medical Associates 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.
* Which Physician did you see today?
* When did you see the Physician?
* How did you hear about us? Physician Referral
Family/Friend
Radio
Signage
Telephone Book
Newspaper
Magazine
On-Line
* Did you have trouble finding the clinic? yes
no
* Are our phones answered promptly? yes
no
* Was your hold time minimal? yes
no
* Was the receptionist courteous and helpful? yes
no
* Was the waiting area neat and clean? yes
no
* Did receptionist verify your address and insurance upon arrival for appointment? yes
no
* Was the availability of appointment reasonable? yes
no
* How long was the wait time?
* Was the nurse courteous, helpful and compassionate? yes
no
* Was your phone call returned by nurse in a timely manner? yes
no
* Did the nurse demonstrate good clinical explanations and skills? yes
no
* Did the nurse and staff keep your information private/confidential? yes
no
* Was the amount of time the doctor spent with you adequate? yes
no
* Did he/she take time to answer your questions? yes
no
* Did the physician provide the information you needed to understand your care? yes
no
* Was the physician friendly, personable, and concerned? yes
no
* Was the wait time in the exam room adequate? yes
no
* Was the facility neat and clean? yes
no
* Rank ease of finding/identifying the Clinic? Great
Good
Ok
Fair
Poor
* Rank privacy, comfort, and safety while waiting? Great
Good
Ok
Fair
Poor
* What is you overall rating of our Clinic? Great
Good
Ok
Fair
Poor
* What is the likely hood of referring your family/friends to the Clinic? Great
Good
Ok
Fair
Poor
  What do you like best about our clinic?
  What could we do to improve our clinic?
  Anyone you would like to recognize for outstanding service?