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Share - Patient Survey

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Patient Survey

We’d like your feedback about your most recent visit to our clinic.

In regards to general aspects of our service...

  Poor Fair Good Very Good Excellent
Ease of making an appointment over the phone
Wait time before seeing the doctor
Friendliness and courteousness of our reception staff
Cleanliness and comfort of our clinic

In regards to your experience with our doctor...

Please Select the doctor who last assisted you at our clinic  

My doctor: Definitely Not Mostly Not Not Sure Mostly Yes Definitely Yes
... spends an appropriate amount of time with me
... listens to me and answers my questions
... is friendly, courteous and respectful towards me
... helps me understand my medical condition(s)
... clearly explains potential method(s) of treatment
... provides me with further information if I request it
... is thorough, careful and competent
... makes decisions and gives recommendations that are in my best interest
... explains to me what I can do to improve my health
... is someone I’d recommend to my family and friends


Is there anything we can do to improve the care and services we provide you?


(please specify)



Some quick questions about you...



Overall how would your rate your overall health?
What is your age?
Are you male or female?
Is our clinic your usual provider of care?