Patient Satisfaction Survey

Citrus Cardiology Consultants, PA would appreciate your assistance. Please take the time to complete this survey to help us evaluate our employees and your visit with us.

Feel free to be as honest as you like and share any comments you feel are pertinent to your experience with us. Your survey will be kept confidential.

When completed please submit to our Practice Administrator by clicking on the "Submit" button at the end of the survey.

Which office are you evaluating?
Date of Visit:
Physician's Name that you visited:
Please read each question carefully, and indicate what best describes your visit or experience.
Were you able to schedule your appointment as soon as you wanted? Yes No
Was this your first visit to Citrus Cardiology? Yes No
Were you greeted and treated courteously by reception when you arrived? Yes No
How long after your scheduled time did you wait to see your physician? 1-10 min.
11-20 min.
21-30 min.
Over 30 min.
Were the exam rooms and lobby clean and tidy? Yes No
When you saw your physician, were you given a chance to explain the reasons for your visit? Yes No
When you asked questions, did you get an answer you could understand? Yes No
Did your physician explain the purpose or results of any tests or procedures in a way you could understand? Yes No
Did someone explain the purpose of any medication(s) in a way you could understand? Yes No
Did someone explain any side effects of the medication(s) in a way you could understand? Yes No
Did your physician explain what to do if problems or symptoms continued, got worse, or returned? Yes No
Were you involved in decisions about your care as much as you wanted? Yes No
Was your physician familiar with your most recent medical history? Yes No
Did you have confidence and trust in the physician you saw? Yes No
Did you have trouble understanding your physician because of language differences? Yes No
Were you treated with courtesy and respect by your physician during your visit? Yes No
Were you treated with courtesy and respect by the staff during your visit? Yes No
Overall, how would you rate the quality of care you received during your visit? Excellent
Very Good
Good
Fair
Poor
Overall, how would you rate the office, staff and physicians? Excellent
Very Good
Good
Fair
Poor
Please feel free to share any comments you have about your recent visit, or let us know anything we can do to make this practice better for you and your family.
All information will be confidential and used only by Citrus Cardiology Consultants, P.A. as a guide to serve their patients better. 
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