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Wayne Neurology Patient Satisfaction Survey
We value your opinion and want to know how we're doing. Please take the next 5 or so minutes to complete this survey
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How would you rate your experience with our telephone courtesy?
Excellent
Very Good
Good
Fair
Poor
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How would you rate our hours?
Excellent
Very Good
Good
Fair
Poor
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How would you rate the amount of time you spent in the waiting room?
Excellent
Very Good
Good
Fair
Poor
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How would you rate the amount of time you spent in the exam room?
Excellent
Very Good
Good
Fair
Poor
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How would you rate the amount of time you spent with the doctor?
Excellent
Very Good
Good
Fair
Poor
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How would you rate your experience with our front office staff?
Excellent
Very Good
Good
Fair
Poor
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How would you rate your experience with our nurse/medical staff?
Excellent
Very Good
Good
Fair
Poor
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How would you rate your experience with the doctor?
Excellent
Very Good
Good
Fair
Poor
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How would you rate our respect for your time/informing you of delays?
Excellent
Very Good
Good
Fair
Poor
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How would you rate the appearance of our office?
Excellent
Very Good
Good
Fair
Poor
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Overall, how would you rate the care and service provided from this office?
Excellent
Very Good
Good
Fair
Poor
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If you had the option to go anywhere for treatment, how likely would you return to our office?
Very likely
Likely
Neither likely nor unlikely
Unlikely
Very unlikely
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Did you have any testing in our office today? If yes indicate which of the following tests you had
EEG
VNG
BAER
Balance Assesment
SEP
EMG
I did not have any tests done
How friendly was the technician?
not friendly at all
1
2
3
4
5
very friendly
Clear selection
How professional was the technician?
not professional at all
1
2
3
4
5
very professional
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How knowledgeable and helpful was the technician?
not knowledgeable or helpful
1
2
3
4
5
very knowledgeable and helpful
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How accurately were testing policies explained by the technician?
not accurately at all
1
2
3
4
5
very accurately
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Overall, how satisfied were you with the services you received?
Very unsatisfied
1
2
3
4
5
Very Satisfied
Clear selection
Please explain any unsatisfactory experiences you had with our services and tell us how we can improve them
Your answer
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