HeySurvey survey

Patient Experience Survey 🩺

In the last 6 months, how often did you get an appointment for care as soon as you needed?*

Think about how easy it was to get care when it felt urgent.

1

2

3

4

5

Never to Always

How often did the staff treat you with courtesy and respect?*

Please focus on your most recent visits.

1

2

3

4

5

Never to Always

When you contacted the office, how often did you get answers to your medical questions the same day?*

This includes phone calls, messages, or portal questions.

1

2

3

4

5

Never to Always

Which parts of your visit went well?

Choose all that apply.

Scheduling the appointment
Check-in process
Time spent waiting
Helpfulness of staff
Provider communication
Follow-up instructions

How clearly did the provider explain things in a way that was easy to understand?*

Think about whether the information felt simple and clear.

1

2

3

4

5

Not at all clearly to Very clearly

Did you feel the provider listened carefully to you?*

Choose the option that best matches your experience.

Yes, definitely
Yes, somewhat
No

What could we do to improve your experience?

Share any ideas that would make visits easier or better.

How would you rate this provider overall on a scale from 0 to 10?*

Where 0 is the worst possible provider and 10 is the best possible provider.

0

1

2

3

4

5

6

7

8

9

10

From Least to Most

Would you recommend this provider’s office to friends or family?*

Please choose the answer that best reflects what you would tell others.

Definitely yes
Probably yes
Probably no
Definitely no

Thank you for taking a part in this survey.