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Patient Forms
Contact

Home
Services
- Diabetes Clinic
Accepted Insurance
Patient Forms
Contact

Call Today 1 (407) 962-4447 204 W Oak Street Kissimmee, FL 34741

Open Hours Mon - Fri 7:30am - 4:00pm Lunch 12:00pm - 1:00pm

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Osceola Endocrine Consultants > Physician Office Survey

Physician Office Survey

PLEASE COMPLETE AFTER YOUR APPOINTMENT

Please help us care for you by providing feedback about your experience with our office and staff. This feedback helps us continually monitor or change our systems to serve you better.

Physician Name:

Your Name:

Telephone:

E-mail:

Date of Appointment

Time of Appointment (optional)

Before Your Visit: How would you rate the following:

Ease in getting through to us by phone
ExcellentVery GoodGoodFairPoorDoes Not Apply

Courtesy of staff taking your call
ExcellentVery GoodGoodFairPoorDoes Not Apply

Time between making appointment and visit date
ExcellentVery GoodGoodFairPoorDoes Not Apply

Convenience of office hours
ExcellentVery GoodGoodFairPoorDoes Not Apply

Convenience of office hours
ExcellentVery GoodGoodFairPoorDoes Not Apply

Ease in seeing the doctor of your choice
ExcellentVery GoodGoodFairPoorDoes Not Apply

At the time of your visit:

Was our receptionist courteous and helpful?
ExcellentVery GoodGoodFairPoorDoes Not Apply

Waiting time to see the doctor - How long did you wait?
ExcellentVery GoodGoodFairPoorDoes Not Apply

Waiting time to see the doctor - How long did you wait?
10 minutes or less10-20 minutesmore than 20 minutes

Amount of time doctor spent with you
ExcellentVery GoodGoodFairPoorDoes Not Apply

Doctor’s explanation of what was done (ie: tests, diagnosis, treatment)
ExcellentVery GoodGoodFairPoorDoes Not Apply

Doctor’s personal manner (courtesy, respect, sensitivity)
ExcellentVery GoodGoodFairPoorDoes Not Apply

Doctor’s instructions regarding medications & follow-up
ExcellentVery GoodGoodFairPoorDoes Not Apply

Overall quality of care you received
ExcellentVery GoodGoodFairPoorDoes Not Apply

Were you given enough privacy
ExcellentVery GoodGoodFairPoorDoes Not Apply

Enough time and comfort to ask questions
ExcellentVery GoodGoodFairPoorDoes Not Apply

Enough time and comfort to ask questions
ExcellentVery GoodGoodFairPoorDoes Not Apply

Was our check out person courteous and helpful?
ExcellentVery GoodGoodFairPoorDoes Not Apply

Likelihood that you would recommend us to a friend or relative
ExcellentVery GoodGoodFairPoorDoes Not Apply

How useful is the information on the site?

How can we improve the site?

What would you like us to add to the site?

Any other comments or suggestions you might have.

Osceola Endocrine Consultants Inc. 204 W Oak Street Kissimmee, FL 34741 Phone: (407) 962-4447

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