When you called or were called to make an appointment, your conversation was:
very professional and courteous
transferred many times
on hold for a long time
rude and unprofessional

Your first impression when checking in was:
warm and friendly with a smile
nice and short
not acknowledged
nobody present

Were you seen for your appointment in a timely manner?
promptly
less than 15 minutes
more than 15 minutes
had to reschedule

Did you understand the treatment provided and the available alternatives?
completely understood
somewhat understood
somewhat confused
completely confused

Did you feel insurance and billing were properly and thoroughly explained (in regard to your most recent treatment and future treatment needed)?
Yes
No

If no, please explain:

When you asked a staff member a question, they were
very knowledgeable
knowledgeable
had to ask someone else
never answered my question

How was your interaction with (please select one in each row):

Further comments, if any:

Name (optional):

Email (optional):

Phone (optional):

Year of Visit (i.e., 2006, 2007, etc.):

Thank you for taking the time to complete this survey.