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2012
September
A
ABJC Test Survey
ABJC Test Survey
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Hello Earthling:
You are invited to participate in our clinic survey. In this survey, approximately
7 billion
people will be asked questions about our clinic's operation and procedures. It will take
literally 60 seconds
to complete the questionnaire.
Your participation in this study is completely voluntary. There are foreseeable risks associated with this project (diarrhea, loss of vision, temporary loss of hearing),
however
, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.
Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact
McGyver
at
(806) 468-9700
or by email at the email address specified below.
Thank you very much for your time and support. Please start with the survey now by clicking on the
Continue
button below.
Rock on McGyver
*
Provider seen today
Bjork
Sims
Risko
Veazey
Haseloff
North
PT/OT
*
Overall performance of facility
Excellent
Good
Average
Poor
Very Poor
Comments (please specify)
*
Scheduling - Ease of scheduling appointments
Excellent
Good
Average
Poor
Very Poor
*
Reception - Patients are greeted as soon as they walk in the doors and feel welcomed
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
*
Wait Time - Amount of time waiting to see provider is reasonable
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
*
Office Staff - Staff is friendly and knowledgeable
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
*
Provider - Provider is professional, listens to questions/concerns, and has accurate, knowledgeable answers
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
*
Responsibility/Accountability - All employees are accountable for their actions and take responsibility for patients
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
*
If you were asked to make one change to our office (operating procedures, scheduling, facility, etc.) what would you change, and why?
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