Relentless Pursuit of Perfection

Cholla Medical Group: Patient Satisfaction Survey

We value you as a patient and with each visit we strive to provide exceptional service. We ask you to take a moment to complete this survey. Your participation is sincerely appreciated and will be used to help improve our services.

Who is filling out the survey?

PatientPOAOther

Patient Demographic information

Gender

MaleFemale

Race

WhiteHispanic/LatinAfrican-AmericanOther

Marital Status

SingleMarriedWidowed

Insurance Status

MedicareMedicaidCommercial (BCBS, Cigna, Aetna, etc.)Uninsured

Full Time AZ Resident

YesNo

Please let us know how well you think we are doing in the following areas

1) Ease of getting care
Great Good OK Fair Poor N/A
Ability to be seen for a check-up or routine care Great Good OK Fair Poor N/A
Ability to be seen for care you needed right away Great Good OK Fair Poor N/A
Convenience of office hours Great Good OK Fair Poor N/A
Phone call hold times kept under 5 minutes Great Good OK Fair Poor N/A

 

Comments regarding Ease of Getting Care?

2) Customer Service (Receptionists)
Great Good OK Fair Poor N/A
Friendly and helpful to you Great Good OK Fair Poor N/A
Treats you with courtesy and respect Great Good OK Fair Poor N/A
Answers your questions Great Good OK Fair Poor N/A

 

Comments regarding Customer Service (Receptionists)?

3) Medical Assistants
Great Good OK Fair Poor N/A
Friendly and helpful to you Great Good OK Fair Poor N/A
Treats you with courtesy and respect Great Good OK Fair Poor N/A
Answers your questions Great Good OK Fair Poor N/A

 

Comments regarding Medical Assistants?

4) Your Primary Care Physician

Please select your primary care physician:

Great Good OK Fair Poor N/A
Listens to you Great Good OK Fair Poor N/A
Takes enough time with you Great Good OK Fair Poor N/A
Explains what you want to know Great Good OK Fair Poor N/A
Gives you good advice and treatment Great Good OK Fair Poor N/A

 

Comments regarding Your Primary Care Physician?

5) Follow-Up Care
Great Good OK Fair Poor N/A
Informed of results on labs and tests ordered
Prompt refills of medications within 3 business days Great Good OK Fair Poor N/A
Prompt answers/return of phone calls about medical questions Great Good OK Fair Poor N/A

 

Comments regarding Follow-Up Care?

6) Would you refer us to friends and family?
Great Good OK Fair Poor N/A
The likelihood of referring your friends and relatives to us: Great Good OK Fair Poor N/A

Please answer the following questions:

7) Approximately how long have you been a patient with this practice?

Less than 6 monthsAt least 6 months but less than 1 yearAt least 1 year but less than 3 yearsAt least 3 years but less than 5 years5 years or more

8) If you are no longer a patient in our practice, why did you leave?

LocationPhysicianOfficeStaffThis question does not apply to meOther

9) How did you hear about our practice?

Friend or family memberAnother physician/specialistHealth plan/insurance company or associated directoryOnlineOther

Please answer the following questions about the survey

10) Were the survey questions easy to understand?

YesNo

11) Was the survey easy to complete?

YesNo

12) Approximately how long did it take to finish this survey?

5 minutes or less10 minutes15 minutes20 minutes or longer

Additional Comments