Patient Satisfaction Survey

Direct feedback helps us continuously improve patient care and other services.
We appreciate you taking the time to complete this Patient Satisfaction Survey.

  • (Where was your appointment ? )
  • Please rate the statements below using the following scale:

  • 1 = Very Dissatisfied
  • 2 = Somewhat Dissatisfied
  • 3 = Somewhat Satisfied
  • 4 = Very Satisfied
  • NA = Not Applicable
  • 1234NA
    1.Telephone answered promptly
    2.Courteous and caring attitude of staff scheduling appointment
    3.Convenience of appointment time
    4.Convenience of the location
    5.Directions to office offered
    6.You Received a call from the office reminding you of this appointment
  • 1234NA
    1.Ease of parking and access to the building
    2.Prompt check-in process
    3.Courteous and caring check-in staff
    4.Effectiveness of check-in staff in handling registration
    5.Follow-up appointment handled efficiently
    6.Co-pay and insurance issues handled efficiently
    7.Effectiveness of handling referral request
    8.Courteous and caring attitude of referral coordinator
  • 1234NA
    1.Wait time before being seen by clinician/physician
    2.Courteous and caring attitude of clinical staff (nurses, lab techs, x-ray techs)
    3.Courteous and caring attitude of physician
    4.Physician explained medical issues thoroughly
    5.Understanding of your condition after your visit
    6.Environment pleasant and clean
    7.Educational materials presented to you regarding your condition
  • 1234NA
    1.Courteous and caring attitude of billing staff
    2.Billing questions were explained thoroughly
    3.Billing inquires left on voice mail were returned with in 24 - 48 hours or 1 - 2 business days
  • YesNo
    1.Would you return to Virginia Physicians, Inc.?
    2.Would you recommend Virginia Physicians, Inc. to your family and friends?

  • This field is for validation purposes and should be left unchanged.
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