Questionnaire

Would you take a few minutes of your time to help us? Our goal is to provide comfort, convenience, and satisfaction, as well as the very best in medical care to all our patients. Therefore, we'd like to know how you feel about our medical services, our patient-handling systems, and our doctors and staff members.

Your responses will help us evalute our operations to ensure that we are truly responsive to your needs.


* optional information

What is your:

First Name*

Last Name*
Email Address*

Who is your Doctor?

HOW SATISFIED ARE YOU WITH

Your Appointment
Appointment available within a reasonalble amount of time.
Appointment scheduled at a convenient time of day
Waiting time in the reception area
Waiting time in the exam room
   

Our Staff

The friendliness and courtesy of our receptionist
The caring concern of our nurses
The helpfulness of the people in our business office
   

Our Communication with You
Your phone calls answered promptly
Availability of medical information/advice by telephone
Explanation of your test procedure (if applicable)
Your test results reported in a reasonable amount of time
Effectiveness of our health information materials
The doctor returning your calls in a timely manner
  

Your Visit with the Doctor
The doctor listened to you

The doctor taking time to answer your questions
The doctor adequately explaining treatment options
The thoroughness of the examination
Amount of time the doctor spent with you
The outcome of treatment prescribed by your doctor
         

OVERALL RATING
Excellent
Good
Fair
Poor
Our Practice
The Quality of Your Medical Care

Comments*

 

Office Location:

St. Thomas Medical Plaza East
4230 Harding Road, Suite 527
Nashville, TN 37205

Phone:  615.386.3067
Fax:      615.385.0612

Office Hours:

Monday thru Friday
8:00 a.m. - 5:00 p.m.

 

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endocrinology ~ diabetes associates
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