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practitioners

Tell us what you think!

In an effort to assist us to improve the service we provide our patients, we ask that you take a moment to complete the following survey. Your candid responses and comments will help us institute changes to improve our processes and make your experience with us a more pleasant one. Thank you.


If you are completing this survey in response to a particular date of service or staff member, indicate that information here:

Date: Staff:

1. How would you rate our automated telephone system?

    Excellent   Very Good   Good   Fair   Poor
2. How would you rate the friendliness and helpfulness of our receptionists both during check-in and check-out?
    Excellent   Very Good   Good   Fair   Poor
3. How satisfied were you with the length of time you had to wait to get an appointment?
    Excellent   Very Good   Good   Fair   Poor
4. How would you rate the medical assistant who took brought you to the exam room? Did you find her to be knowledgeable, courteous and caring?
    Excellent   Very Good   Good   Fair   Poor
5. How would you rate the amount of time spent in our office from the start to finish of your appointment.
    Excellent  Very Good  Good  Fair  Poor
6. How professional, compassionate and helpful did you find your healthcare provider to be?
    Excellent  Very Good  Good  Fair  Poor
7. How would you rate the ease of obtaining test results?
    Excellent  Very Good  Good  Fair  Poor
8. When calling to speak to our nurse with a problem, how satisfied were you with the promptness and response of your returned phone call?
    Excellent  Very Good  Good  Fair  Poor
9. How would you rate the ease of obtaining referrals?
    Excellent  Very Good  Good  Fair  Poor
10. What are we doing especially well?
    Comments:
11. In your opinion, what could we do to improve our practice?
    Comments:
12. Please list your age:
    Age:
13. Please list your health plan / insurance:
    Health Plan:

14. Please list any comments below. Feel free to provide any positive or negative feedback you may have. Also, if there is a particular Staff Member or Health Care Professional who provided exceptional service we'd like to know. Thank you again for your time.

    Comments:

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Obstetrics & Gynecology Associates | email: info@website.com | Phone: 856-262-8300 | Fax: 856-262-1635
239 Hurffville-Crosskeys Road, Ste 250 | Sewell, NJ 08080 | Gloucester County | Read Disclaimer

Obstetrics & Gynecology Associates is a division of the Regional Women's Health Group - NJ
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