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Dear Patient: Our goal is to provide comfort, convenience, and satisfaction as well as the very best medical care to all our patients. We'd like to know how you feel about our medical services, our patient-handling systems, our physicians and staff members. Your comments will help us evaluate our operations to ensure that we are truly responsive to your needs. Thank you for your help.
 
Male Female   Yes No
Gender Did you have an appointment today?
 
Under-18 18-30 30-50 50-64 65+
What is your age group?
Primary Care Ob/Gyn Cardiologist Allergist Physical Ther
What type of physician are you seeing today?
Bedford Blvd Third Ave Ft Washingto Wadsworth Nagle Ave
Bronx Bronx Manhattan Manhattan Manhattan
Which location are you rating?
 
Very Somewhat   Very Totally
Appointment Dissatisfied Dissatisfied Satisfied Satisfied Delighted
Ease of scheduling your appointment
Helpfulness of the receptionist
Efficiency of the check in process
Waiting time in reception area
Staff          
Addressing your health needs in a timely manner
Staffs familiarity with you (did they know your name?
Courtesy and concern of the medical assistant
Physician's willingness to listen your concerns
Physician taking time to explain your care/ meds
Time the physician spent with you
Thoroughness of the exam
Test results reported in a timely manner
Facility          
Convenience of hours of operation
Cleanliness of bathrooms
Cleanliness of office
Overall comfort of office
Overall experience of our office
  Definitely Probably Don't Probably Definitely
  Yes Yes Know No No
Would you recommend US to others?
Comments: