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  2. 2013
  3. July
  4. P
  5. PCMH Survey 2
0%
Exit Survey
 
 
In the last 12 months, how often were clerks and receptionists at this provider’s office as helpful as you thought they should be?
 
Never
 
Sometimes
 
Usually
 
Always
 
 
 
In the last 12 months, how often did clerks and receptionists at this provider’s office treat you with courtesy and respect?
 
Never
 
Sometimes
 
Usually
 
Always
 
 
 
n general, how would you rate your overall health?
 
Excellent
 
Very Good
 
Good
 
Fair
 
Poor
 
 
 
What is your age?
 
18 to 24
 
25 to 34
 
35 to 44
 
45 to 54
 
55 to 64
 
65 to 74
 
75 or older
 
 
 
Are you male or female?
 
Male
 
Female
 
 
 
Are you of Hispanic or Latino origin or descent?
 
Yes, Hispanic or Latino
 
No, Not Hispanic or Latino
 
 
 
Whatis your race? Mark one or more
 
White
 
Black or African‐American
 
Asian
 
Native Hawaiian or other Pacific Islander
 
American Indian or Alaska Native
 
Other
 
 
 
What is the most important to you?
 
On-time
 
Same day/Next day promise
 
Integrated Team
 
Ability to have phone app 24/7
 
Ability to go to any AHC location and have your records available.
 
 
 
On a scale of 0 to 10 (10 being highly likely), how likely are you to recommend Arrowhead Health Centers to family and friends?
 
0
 
1
 
2
 
3
 
4
 
5
 
6
 
7
 
8
 
9
 
10
 
 
 
Will you explain what you liked about your visit? If yes, please explain.
 
Yes
 
No