Patient Satisfaction Survey Please take a moment to take this Patient Satisfaction Survey. It would help us enhance our practice and serve our patients better. Name Email Phone How long did you have to wait (after your appointment)? Not very long (10-20 minutes) Longer than usual (20-30 minutes) Very long (more than 30 minutes) Was the staff polite? Yes No On a scale of 1-5 how would you rate your appointment experience Where 1 being the lowest (I did not find it fruitful) and 5 being the highest (I am completely satisfied with my appointment) Not Satisfied Satisfied Do you believe there are enough appointment times available? Yes, there are enough slots No, there can be more slots Did the payment options meet your expectations? Yes, there are enough payment options No, there can be more options (please specify below, if any suggestions) Time is Up! Time's up
