We Welcome Your Opinion…

    Our goal is to provide the best possible patient care while giving you the best possible patient service. To help us improve, we would appreciate your responses to the following questions.

    Dr. Ayodeji

    Dr. Beazlie

    Dr. Nguyen

    Dr. Semret

    Dr. Siu

    Dr. Wang

    Linda Jones-Brandon, CFNP

    Robert Song, PA

    Appointment Location:

    Date of Appointment:

    About Our Office

    EXCELLENT

    VERY GOOD

    GOOD

    FAIR

    POOR

    1

    How easy was it to schedule your appointment ?

    ExcellentVery GoodGoodFairPoor

    2

    Are our office hours convenient ?

    ExcellentVery GoodGoodFairPoor

    3

    Availability of appointments ?

    ExcellentVery GoodGoodFairPoor

    4

    Did the staff treat you with courtesy and respect ?

    ExcellentVery GoodGoodFairPoor

    5

    Were you seen in a reasonable amount of time after you arrived ?

    ExcellentVery GoodGoodFairPoor

    About Your Medical Care

    EXCELLENT

    VERY GOOD

    GOOD

    FAIR

    POOR

    1

    Did the Doctor/Nurse Practitioner treat you with courtesy and respect?

    ExcellentVery GoodGoodFairPoor

    2

    Are our office hours convenient ?

    ExcellentVery GoodGoodFairPoor

    3

    Availability of appointments ?

    ExcellentVery GoodGoodFairPoor

    4

    Did the staff treat you with courtesy and respect ?

    ExcellentVery GoodGoodFairPoor

    In General

    EXCELLENT

    VERY GOOD

    GOOD

    FAIR

    POOR

    1

    The likelihood of referring your friends and relatives to us?

    ExcellentVery GoodGoodFairPoor

    2

    Overall, how would rate your visit?

    ExcellentVery GoodGoodFairPoor

    3

    Do you have any other comments or suggestions you would like to make?

    Leave a Reply

    Your email address will not be published. Required fields are marked *