Patient Survey

We would love to hear your comments!

Patient service is important to us and we'd like to know how you feel about our medical services, communication systems, and our providers and staff members. Your honest comments will help us continue to evaluate our operations to ensure that we are truly responsive to your needs. Thank you for choosing our practice and taking time to tell us how you feel!

YOUR APPOINTMENT
Ease of making appointments by phone Excellent Good Poor N/A
How satisfied were you with the availability of getting an appointment Excellent Good Poor N/A
Please rate the efficiency of our check in and check out process Excellent Good Poor N/A
Keeping you informed if your appointment time was delayed Excellent Good Poor N/A
How would you rate your waiting time in the exam room Excellent Good Poor N/A
Please rate ease of getting referrals and other recommended testing Excellent Good Poor N/A
Comments:
OUR STAFF
Courtesy and helpfulness of the person who took your phone call Excellent Good Poor N/A
Friendliness and helpfulness of our staff with the check in and check out process Excellent Good Poor N/A
How would you rate the medical assistant who escorted you to the exam room? Did you find her to be professional and concerned for your care Excellent Good Poor N/A
When calling to speak to one of our triage nurses, how would rate their knowledge and compassion for your medical concern Excellent Good Poor N/A
How would you rate the professionalism and friendliness of our staff in the lab and ultrasound Excellent Good Poor N/A
When scheduling a surgical procedure, how would you rate the helpfulness and professionalism of the surgical scheduling staff Excellent Good Poor N/A
Comments:
YOUR VISIT WITH THE PROVIDER
Name of the provider you saw at the time of your visit:
Willingness to listen carefully to you Excellent Good Poor
Taking time to answer your questions and explained things in a way you could understand Excellent Good Poor
How professional and compassionate did you find the provider to be Excellent Good Poor
Instructions regarding medication and/or follow up care Excellent Good Poor
How would rate the thoroughness of the exam Excellent Good Poor
Comments:
OUR COMMUNICATION WITH YOU
How satisfied are you with the response time from our triage nurses Excellent Good Poor N/A
Please rate your satisfaction with return calls from our Providers Excellent Good Poor N/A
Your test results reported in a reasonable amount of time Excellent Good Poor N/A
Explanation of your procedure and efficiency in our scheduling process (if applicable) Excellent Good Poor N/A
Your ability to contact us after hours Excellent Good Poor N/A
How satisfied were you with our health information materials Excellent Good Poor N/A
Comments:
OUR FACILITY
Please rate your overall impression of our facility; waiting areas, exam rooms Excellent Good Poor N/A
ADDITIONAL COMMENTS:
Please provide any other positive or negative feedback regarding our practice. If there is a particular staff member or provider who you feel provided exceptional patient service we would love to know. Thank you again for your time in completing this survey.
SOME INFORMATION ABOUT YOU:
Your Age (optional): Under 18
18-30
31-40
41-50
51-64
65+
Are You: A new patient
A returning patient
Security Code
Enter Security Code Above

Voorhees office: 2401 Evesham Road, Suite A, Voorhees, NJ 08043
Phone: (856) 424-3323 Fax: (856) 424-4994

Moorestown office: 110 Marter Avenue, Suite 504, Moorestown, NJ 08057-3116
Phone: (856) 642-6580 Fax: (856) 273-8372


Garden State Obstetrical & Gynecological Associates, an Axia Women's Health Care Center
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