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Hello Earthling:
You are invited to participate in our clinic survey. In this survey, approximately 7 billion people will be asked questions about our clinic's operation and procedures. It will take literally 60 seconds to complete the questionnaire.

Your participation in this study is completely voluntary. There are foreseeable risks associated with this project (diarrhea, loss of vision, temporary loss of hearing), however, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.

Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact McGyver at (806) 468-9700 or by email at the email address specified below.

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

 
 
 
 
* Provider seen today
 
Bjork
 
Sims
 
Risko
 
Veazey
 
Haseloff
 
North
 
PT/OT
 
 
 
* Overall performance of facility
 
Excellent
 
Good
 
Average
 
Poor
 
Very Poor
 
Comments (please specify)
 
 
 
* Scheduling - Ease of scheduling appointments
 
Excellent
 
Good
 
Average
 
Poor
 
Very Poor
 
 
 
* Reception - Patients are greeted as soon as they walk in the doors and feel welcomed
 
Strongly Agree
 
Agree
 
Neutral
 
Disagree
 
Strongly Disagree
 
 
 
* Wait Time - Amount of time waiting to see provider is reasonable
 
Strongly Agree
 
Agree
 
Neutral
 
Disagree
 
Strongly Disagree
 
 
 
* Office Staff - Staff is friendly and knowledgeable
 
Strongly Agree
 
Agree
 
Neutral
 
Disagree
 
Strongly Disagree
 
 
 
* Provider - Provider is professional, listens to questions/concerns, and has accurate, knowledgeable answers
 
Strongly Agree
 
Agree
 
Neutral
 
Disagree
 
Strongly Disagree
 
 
 
* Responsibility/Accountability - All employees are accountable for their actions and take responsibility for patients
 
Strongly Agree
 
Agree
 
Neutral
 
Disagree
 
Strongly Disagree
 
 
 
* If you were asked to make one change to our office (operating procedures, scheduling, facility, etc.) what would you change, and why?
   
 
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