Patient Satisfaction Survey - Taos Medical Group

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Patient Satisfaction Survey

* Indicates required field

Were you happy with the amount of time it took to get an appointment with your physician? *

Not Happy Somewhat Uunhappy Somewhat Happy Happy

Were you happy with the amount of time your physician spent during your visit? *

Not Happy Somewhat Unhappy Somewhat Happy Happy

Did your physician answer all your questions to your satisfaction? *

Not Satisfied Somewhat Unsatisfied Somewhat Satisfied Satisfied

Did the office staff treat you with courtesy and respect during your visit? *

No Respect Somewhat Disrespectful Somewhat Respectful Respect

Please rate your overall satisfaction with this visit: *

Poor Fair Good Excellent

Additional Comments *

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