Patient Satisfaction Survey

As a patient of Manchester OB/GYN Associates, we would like to thank you for entrusting us with your medical care. Our goal is to continue to provide the best medical care in a caring, friendly and convenient way. We are providing you with the following survey because we would like to know your impression and feelings about many aspects of our office. We will use this information to improve the quality of services we provide. Thank you for taking the time to complete this survey.
 
Location
Are the practice locations in Manchester/Londonderry convenient?
 Yes  No 
Check-In/Reception
Are you a new patient?
 Yes  No 
Were the receptionists friendly and professional?
 Yes  No 
Was the reception area/waiting room clean and comfortable?
 Yes  No 
Was your appointment scheduled at a convenient time for you?
 Yes  No 
Did you have to wait more than 10 minutes from your appointment time before the medical assistant brought you down to the office/exam room?
 Yes  No 
If you had to wait more than 10 minutes from your appointment time, did the receptionist inform you that the provider was running late?
 Yes  No  N/A 
Provider Care
Did you feel your provider spend enough time with you at your appointment?
 Yes  No 
Were your concerns/questions adequately addressed by the provider?
 Yes  No 
Would you recommend the providers at Manchester OB/GYN Associates to a friend?
 Yes  No 
Did the medical assistant introduce herself and give clear instructions to you?
 Yes  No 
Was the medical assistant friendly and professional?
 Yes  No 
Check-out/Billing
Was the billing/cashier staff friendly and courteous when you checked out from your appointment?
 Yes  No 
Communication/General
Did you receive your results in a timely fashion?
 Yes  No  N/A 
If you spoke to one of our physician co-ordinators where they friendly and professional over the phone?
 Yes  No  N/A 
If you left a message on our voice mail for the physician co-ordinators did you receive a return call within 2 hours?
 Yes  No  N/A 
Did you feel you received appropriate and adequate information from our physician co-ordiantors?
 Yes  No  N/A 
How did you hear about Manchester OB/GYN?
How would you rate your overall satisfaction with your Manchester OB/GYN Associates?
 
Least satisfied
 
 1  2  3  4  5 
 
Highly satisfied
 
What can we do to improve our services at Manchester OB/GYN Associates
May we contact you to discuss your responses?
 Yes  No 
Name (optional) and phone number: