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Anonymous Survey
Location:
Specialty:
Physician:
1. Appointment availability:
2. Wait time in the office:
3. The staff’s personal manner
(courtesy, respectful, friendly):
4. The physician’s personal manner
(courtesy, respectful, friendly):
5. Preparedness of the staff
for your visit or procedure:
6. My physician spent adequate
time with me and answered all
of my questions clearly:
7. The service and care provided
was valuable to improving
my health:
8. I would return to see
this physician for further care:
9. Comments or Suggestions
for PMA Medical Specialists:
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