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PATIENT SURVEY — EMPIRE STATE MEDICAL ASSOCIATES — Dr. Jack Resnick – The Roosevelt Doctor
16649
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PATIENT SURVEY — EMPIRE STATE MEDICAL ASSOCIATES — Dr. Jack Resnick

Dear Patient:

I am interested in finding out how you feel about various aspects of my office practice. Please take a minute to complete this anonymous questionnaire about your visit to my office today. Your responses are confidential and are greatly appreciated. Thank you.

1. The convenience of the office location.

2. The accessibility of the office. (Is the office easy to find, is handicapped entrance adequate, etc.)

3. The comfort of the reception area.

4. The attractiveness of the reception area.

5. The comfort of the examining room(s).

6. The cleanliness of the office, reception & examination room.

7. The promptness with which our telephones are answered.

8. The courtesy of the staff.

9. The amount of time spent with Dr. Resnick.

10. The communication with Dr. Resnick.

11. The quality of the care you received.

12. The privacy of physician’s consultation & examination.

13. Overall, how would you rate your experience?

We appreciate your feedback and will use it to make improvements in the future.