Patient Feedback

 

 

Please take a few minutes to fill out this survey on the timeliness and quality of the service you recieved today.  Canyon View Medical Group welcomes your feedback and your answers will be kept confidential.

   

How would you rate our concern for your privacy?
How often have you visited CVMG within the past year?
How easy was it to make an appointment by telephone?
Was it easy to make an appointment within a reasonable period of time?
How long did you wait to speak to a scheduling staff member?
Was the person who scheduled your appointment courteous and helpful?
If you were seeking a referral to a specialist, was your request handled in a timely manner?
How would you rate the courtesy of the staff at the reception desk?
How long did you wait in the reception area beyond your scheduled appointment time?
How long did you wait in the exam room before the physician appeared?
Which department did you visit during your appointment?
How would you rate the competence of the nurse who helped you?
How would you characterize the concern that the nurse showed for your problem?
Did the nurse respond to your requests within a reasonable period?
Were you able to see the doctor of your choice?
Did you feel that your doctor spent an adequate amount of time with you?
Mark the boxes that characterize the demeanor of your doctor:
How would you rate the competence of your doctor?
Did you feel that your doctor's examination was thorough?
Please rate the clarity of the doctor's explanation of your condition and treatment options:
How well did your doctor include you in healthcare decisions?
Were your questions answered to your satisfaction?
Would you recommend this facility and its staff to your family and friends?
How would you rate the professionalism and competence of the person who took your blood and worked on your lab exam?
If you received a lab exam, please indicate the type(s) of lab exam you received:
If you received a lab exam, was the service prompt, comfortable, and courteous?
Please list any areas in which our service could be improved.
Please share any additional comments.
Name:
Address:
Telephone:
E-Mail:
Date of Visit:*
Please indicate which office you visited:*
Would you like someone to contact you regarding your responses on this survey?

Thank you for taking the time to fill out our survey.  We rely on your feedback to help us improve our services.  Your input is greatly appreciated.

General Health Guidelines

Health Guidelines for Children and Adolescents

Health Guidelines for Women