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In this survey, you will be asked to answer questions about Northwest Urology Clinic. It will take approximately 15 minutes to complete the questionnaire.


Your participation is very important.


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* Which of the following best describes the department you work in?
 
Clerical
 
Clinical
 
Other
 
 

* Which of the following best describes your position here?
 
Receptionist
 
Medical Records
 
Patient Accounts
 
RN
 
LPN / MA
 
Other
 
 

* Overall how satisfied are you with your position at this company?
 
Very dissatisfied
 
Somewhat dissatisfied
 
Not satisfied or dissatisfied
 
Somewhat Satisfied
 
Very Satisfied
 
 
 
If Dissatisfied, what would help to make this a better place for you to work?
   
 
 
Please indicate your level of agreement with each of the following statements.

* Do you feel that employees are recognized as individuals and valued as employees?
 
Always
 
Usually
 
Sometimes
 
Rarely
 
Never
 
Not Sure
 
 

* How motivated are you to see the Northwest Urology Clinic succeed?
 
Very Motivated
 
Somewhat Motivated
 
Not Very Motivated
 
Not at all Motivated
 
Not Sure
 
 

* Administration clearly communicates its goals and strategies to me?
 
Strongly Agree
 
Somewhat Agree
 
Don't agree or Disagree
 
Somewhat Disagree
 
Strongly Disagree
 
 

* How flexible is Administration with respect to your family responsibilities?
 
Very Flexible
 
Somewhat Flexible
 
Neither
 
Somewhat Inflexible
 
Very Inflexible
 
 

* Northwest Urology Clinic provides fair wages.
 
Strongly Agree
 
Agree
 
Neutral
 
Disagree
 
Strongly Disagree
 
 

* Would you refer a friend to apply for a job at this company?
 
Definitely
 
Probably
 
Not Sure
 
Probably Not
 
Definitely Not
 
 
 
* What are the positive aspects of your job?
   
 
 

* Have you ever observed or experienced any of the following forms of discrimination or harassment at this company?
 
Racial Discrimination
 
Sexual Harassment
 
Age Discrimination
 
Gender Discrimination
 
Sexual Orientation Discrimination
 
No, none of the above have been observed or experienced
 
 

* I am kept well informed about company plans and progress.
 
Very Satisfied
 
Somewhat Satisfied
 
Undecided
 
Somewhat Dissatisfied
 
Very Dissatisfied
 
 

* There are opportunities available to me to express my ideas to upper management.
 
Very Satisfied
 
Somewhat Satisfied
 
Undecided
 
Somewhat Dissatisfied
 
Very Dissatisfied
 
 

* There is good communication between people in different departments of the company.
 
Very Satisfied
 
Somewhat Satisfied
 
Undecided
 
Somewhat Dissatisfied
 
Very Dissatisfied
 
 

* Companies policies and procedures have been provided to me and are understood.
 
Strongly Agree
 
Somewhat Agree
 
Undecided
 
Somewhat Disagree
 
Strongly Disagree
 
 
 
* Please list any policies or procedures you are unsure of:
   
 
 

* Do you feel you have been adequately trained on HIPAA rules and regulations?
 
Yes
 
No
 
 

* Do you feel you have been adequately oriented to the clinic's Safety Policies?
 
Yes
 
No
 
 

* The physical working conditions (e.g., ventilation, space, cleanliness) are very good.
 
Agree
 
Disagree
 
Neutral
 
 

* Overall, how satisfied are you with the training you received for your present job.
 
Very Satisfied
 
Somewhat Satisfied
 
Neutral
 
Dissatisfied
 
Very Dissatisfied
 
 

* Work assignments are distributed fairly.
 
Agree
 
Disagree
 
Undecided
 
 

* The amount of work I am expected to do on my job is reasonable.
 
Agree
 
Disagree
 
Neutral
 
 

* I have adequate information available which enables me to do my job well.
 
Strongly Agree
 
Agree
 
Neutral
 
Disagree
 
Strongly Disagree
 
 

* I feel my job performance is fairly evaluated.
 
Strongly Agree
 
Somewhat Agree
 
Undecided
 
Somewhat Disagree
 
Strongly Disagree
 
 
 
* What would help you to be more productive in your job?
   
 
 

* There are opportunities for me to cross-train and learn new skills.
 
Strongly Agree
 
Somewhat Agree
 
Neutral
 
Somewhat Disagree
 
Strongly Disagree
 
 

* Sufficient effort is made to get the opinions and ideas of the employees.
 
Strongly Agree
 
Somewhat Agree
 
Neutral
 
Somewhat Disagree
 
Strongly Disagree
 
 

* My department knows enough about other departments within our company.
 
Agree
 
Somewhat Agree
 
Neutral
 
Somewhat Disagree
 
Disagree
 
 

* Overall, how satisfied are you with the spirit of teamwork within NW Urology Clinic?
 
Very Satisfied
 
Satisfied
 
Neutral
 
Somewhat Dissatisfied
 
Dissatisfied
 
 

* Physicians are generally cooperative and understanding.
 
Strongly Agree
 
Agree
 
Neutral
 
Disagree
 
Strongly Disagree
 
 
How would you rate your Administrator in each of the following areas?
* Communication
Poor Average Good Very Good Excellent
 

* Planning and Organizing
Poor Average Good Very Good Excellent
 

* Directing and Coordinating
Poor Average Good Very Good Excellent
 

* Job/Technical Knowledge
Poor Average Good Very Good Excellent
 

* Interpersonal relationship / People skills
Poor Average Good Very Good Excellent
 

* Promotes Good Work Ethics / Sets Good Example for Others
Poor Average Good Very Good Excellent
 

* Overall Leadership
Poor Average Good Very Good Excellent
 
 

* Overall, I feel the Administrator does a good job.
 
Strongly Agree
 
Agree
 
Neutral
 
Disagree
 
Strongly Disagree
 
 

* The Administrator listens to my problems / needs.
 
Agree
 
Disagree
 
Neutral
 
 

* If I make a mistake, the Administrator treats it as an opportunity to learn.
 
Agree
 
Disagree
 
Neutral
 
 

* I receive recognition from the Administrator when I do a good job.
 
Strongly Agree
 
Agree
 
Neutral
 
Disagree
 
Strongly Disagree
 
 

* I receive recognition from Physicians when I do a good job.
 
Strongly Agree
 
Agree
 
Neutral
 
Disagree
 
Strongly Disagree
 
 

* My ideas are welcomed by the Administrator.
 
Strongly Agree
 
Agree
 
Neutral
 
Disagree
 
StronglyDisagree
 
 

* I understand the day-to-day goals and priorities of my job/department.
 
Strongly Agree
 
Agree
 
Neutral
 
Disagree
 
Strongly Disagree
 
 

* My job requirements are clear.
 
Strongly Agree
 
Agree
 
Neutral
 
Disagree
 
Strongly Disagree
 
 

* I get what I need to do my job well.
 
Strongly Agree
 
Agree
 
Neutral
 
Disagree
 
Strongly Disagree
 
 

* I feel stress in my job.
 
Strongly Agree
 
Agree
 
Neutral
 
Disagree
 
Strongly Disagree
 
 

* Is your job stress caused by your relationship with another person you work with?
 
Yes
 
No
 
N/A
 
 

* If your job stress doesn't involve another person, is it caused by the:
 
Volume of Work
 
Nature of the job and its responsibilities
 
Physical Work Environment
 
Personal Health Issue
 
N/A
 
Other
 
 
 

* I am proud to work for Northwest Urolgy Clinic.
 
Strongly Agree
 
Agree
 
Neutral
 
Disagree
 
Strongly Disagree
 
 
 
* What suggestions do you have for improvement of Northwest Urology Clinic?
   
 
 
 
* Please list any issues not included in this survey that need to be addressed by this organization.
   
 
 
 
Please make any open/general comments here:
   
 
Please contact [email protected] if you have any questions regarding this survey.
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