Patient Satisfaction Survey

The Department of Neurosurgery is completely committed to excellent customer service and patient satisfaction. In an effort to continually improve our services, we ask that you please take a brief moment to let us know how we are doing. We thoroughly appreciate your business and thank you in advance for your feedback.

Please rate our office staff in the following areas by circling the number that best
applies:

5 = Excellent
4 = Good
3 = Neutral
2 = Fair
1 = Poor

1. Attitude 5 4 3 2 1 
2. Ease of scheduling appointment 5 4 3 2 1 
3. Handling of insurance/financial questions 5 4 3 2 1 
4. Communication skills of office staff 5 4 3 2 1 
5. Handling of questions/concerns 5 4 3 2 1 
6. Overall office experience 5 4 3 2 1 
7. Date of service
8. Doctor
(Other)

Do you have anything else you would like to share with us about your experience with our practice?

We greatly appreciate you taking the time to help us improve our services!

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