Survey

We strive to provide convenient, compassionate, qualitycare for every patient and your opinion matters to us.

Please respond to the following questions.  This will help us identify opportunities for improvement.  Thank you in advance for taking the time to complete this form.

Location

Which office location did you visit?

Bedford-Harris Methodist	Frisco
Dallas-Medical City	Grapevine
Dallas-Presbyterian	Irving/Las Colinas
Dallas-Woodhill Medical Park	Plano Medical Center
Carrollton	Plano-Presbyterian
Flower Mound

Physician

Which physician did you see?

Dale D. Burleson, M.D.	Randy W. Crim, M.D.	J. Marcus Downs, M.D.
Sharon G. Gregorcyk, M.D.	Jefferson B. Hurley, M.D.	Jennifer K. Lowney, M.D.
Anthony Macaluso Jr., M.D.	F. Clark Odom, M.D.	Don R. Read, M.D.
Clifford L. Simmang, M.D.	Ronney F. Stadler, M.D.

Please indicate your level of satisfaction with the following items related to your office experience:
1. It was easy to schedule an appointment:	1 2 3 4 5 N/A
2. The office staff were professional and helpful:	1 2 3 4 5 N/A
3. The wait time in the office was reasonable:	1 2 3 4 5 N/A

Please rate the following items related to your clinical care:
4. My doctor listened to my concerns:	1 2 3 4 5 N/A
5. My doctor clearly explained my procedure, diagnosis or treatment regimen:	1 2 3 4 5 N/A
6. The medical assistant was courteous and helpful:	1 2 3 4 5 N/A
7. The educational information I received was helpful:	1 2 3 4 5 N/A
8. The care/service was provided was valuable to improving my health:	1 2 3 4 5 N/A
9. During checkout process the staff clearly explained my financial responsibility:	1 2 3 4 5 N/A
10. I would recommend this practice to family and friends:	Yes No

Comments

Please feel free to leave additional comments you would like to share: