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Patient Survey - Worker's Compensation

  1. 1. Wait Time

    How long did you wait in the waiting room/lobby to be seen by a medical professional (doctor or nurse)?

  2. Please rate the following as:

    1. Disagree, 2. Neutral, 3. Agree

  3. 2. The amount of time spent in the exam room before seeing the doctor was acceptable.

  4. 3. The medical professional (doctor/nurse) took time to listen to my concerns and answer my questions.

  5. 4. The facility was neat and clean.

  6. 5. The reception staff was friendly, helpful and nice.

  7. 6. The nursing staff was friendly, helpful and nice.

  8. Please share what went good or what went bad.

  9. Leave This Blank:

  10. This field is not part of the form submission.