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WE VALUE YOUR OPINION

The staff of Injury Specialists is constantly evaluating our response to your needs. Please rate the foloowoing statments as they refer to the treatment and care you received. Check only one box per statment. if a statement does not apply to you, check #5 NA (not-applicable). Your responses are confidential.

Which physician did you see today?
1 = Strongly Agree 2 = Agree 3 = Disagree 4 = Strongly Disagree NA = Not Applicable

1.   I am satisfied with te ease of scheduling my appiontments with the doctor.
2.   The Office staff was accessible and informative for me.
3.   I was treated courteously by the nursing staff.
4.   Telephone calls to injury Specialists are answered promptly.
5.   My financial responsibilities were clearly explained to me.
6.   I was seen at my appointed time.
7.   I am satisfied with the time the physician spent with me.
8.   My treatment plan was clearly explained to me by the physician.
9.   The waiting area is comfortable.
10.  The Treatment rooms are comfortable.
11.  Parking and entrance into the building are easily accessible.
13. I was very pleased with the service I received today.

 

14. If further care/treatment was recommended, do you plan to return to Injury Specialists?

Are there any other services you would like to have provided at Injury Specialists?
If you wish a call back to discuss your opinion, please include your name and phone number



THANK YOU FOR YOUR TIME!