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Dear Patient: The goal at The Women’s Healthcare Group is to provide comfort, convenience and satisfaction as well as the very best medical care to all of our patients. We’d like to know how you feel about our medical services, patient-handling systems, medical providers and staff members. Your comments will help us evaluate our operations to ensure that we are truly response to your needs. We appreciate your taking the time to complete this questionnaire, and thank you for your valuable help.
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| Your Appointment: |
Excellent |
Very
Good |
Good |
Fair |
Poor |
| 1. |
Ease of making appointments by phone. |
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| 2. |
Ease of making appointment through our website. |
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| 3. |
Appointment available within a reasonable amount of time. |
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| 4. |
Efficiency of the check-in process. |
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| 5. |
Waiting time in the reception area |
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| 6. |
Waiting time in the exam room. |
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| 7. |
Keeping you informed if your appointment was delayed. |
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| 8. |
Overall comfort of our facility. |
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| Telephone: |
| 1. |
Calls get through to the office on a prompt basis. |
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| 2. |
Courtesy & helpfulness of the person who took your call |
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| 3. |
Answering service is courteous & handled your call well. |
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| 4. |
Medical Provider returned your call promptly. |
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| Our Staff: |
| 1. |
Reception and office staff were friendly and courteous. |
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| 2. |
Nurses and medical assistants were caring , helpful and answered your questions
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| Website [www.thewhcg.com]: |
| 1. |
Have you visited the website? |
Yes
No |
| 2. |
What was the purpose of your visit to the website? |
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| 3. |
Were you able to find the information you were looking for quickly? |
Yes
No
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| 4. |
Are you aware that you can refill prescriptions and schedule appointments through the patient portal on the website? |
Yes
No
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| 4. |
Do you use the website as a reference tool? |
Yes
No
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Is there something you would like to see added to the site? |
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Visit with the Providers (Doctor, Nurse Midwife, or Nurse Practitioner)
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Excellent |
Very
Good |
Good |
Fair |
Poor |
| 1. |
Willingness to listen carefully to you. |
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| 2. |
Taking time to answer your questions. |
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| 3. |
Amount of time spent with you. |
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Explaining things in a way you could understand. |
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Instructions regarding medication/follow up care. |
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| 6. |
Received helpful educational materials about my health. |
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| 7. |
If sent for tests, I understood what they were for & why needed. |
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| 8. |
Test results reported in a reasonable amount of time. |
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| 9. |
If I had surgery, I understood the procedure & why needed. |
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| How did you hear of us: |
| 1. |
How did you hear of The Women's Healthcare Group? |
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| 2. |
Did you see our latest billboard? |
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Overall Satisfaction with:
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Excellent |
Very
Good |
Good |
Fair |
Poor |
| 1. |
Our Practice. |
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| 2. |
Quality of your medical care |
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If you could improve, or suggest, one thing about our office, it would be:
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I am a current patient: I am a new patient:
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If a new patient, how did you hear about our Practice?
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