Patient Satisfaction Survey

Please mark the appropriate grade (A is the highest, F is the lowest) under each category and click the submit button to complete the survey

THE FACILITY   A    B    C    D    F       N/A
Easy to find      
Clean building      
Finding your way around      
Rooms neat, picked up      
Your comfort while here      
Protection of your privacy      
     
THE APPOINTMENT PROCESS   A    B    C    D    F       N/A
Getting an appointment      
Politeness of the appointment person        
     
WAITING TIME   A    B    C    D    F       N/A
At the reception area      
In the waiting room      
In the examining room      
At the Laboratory      
At X-ray      
At the Pharmacy      
     
YOUR DOCTOR OR NURSE PRACTITIONER   A    B    C    D    F       N/A
Understood what you said      
Took enough time with you      
Was careful and helpful      
Taught you about your condition      
Told you what your lab tests were for      
Told you what your prescriptions or medications were for      
Told you how to take your medications      
Explained ways to stay healthy      
     
SATISFACTION WITH STAFF   A    B    C    D    F       N/A
Receptionists
   
Nurses
   
Physicians
   
Nurse Practitioners
   
Physical Therapy
   
Psychologists
   
Lab Technicians
   
Pharmacists
   
X-Ray Technicians
   
Insurance & Billing Staff
   
     
OVERALL ASSESSMENT YES  NO     N/A
Was your reason for coming taken care of to your satisfaction?      
Did you fully understand your condition?      
If medication was prescribed, did you understand the directions before you left
University Health Services?		    
Would you recommend University Health Services to others?      
What is your overall grade of UHS?    A    B    C    D    F     N/A
   
     
DEMOGRAPHIC INFORMATION
What is your sex?  
Female Male
What is your age?  


Additional Comments Regarding Your Visit

.

Suggestions to Improve Our Services


Thank you for participating in this satisfaction survey!
All responses are anonymous and used only for internal quality improvement  

If you experienced problems completing this survey,
please contact David Bettinger (330.672.8257)