Marketing Research Report Analysis
SoChill14
professional_urologists_questionnaire.docPROFESSIONAL UROLOGISTSPRIVATE
Patient Satisfaction Survey
Conducted by Martian Marketing Research Company
Dear Patient,
Would you take a few minutes of your time to help us? Our goal is provide you with quality service. Your comments will help us evaluate our performance to ensure that we are responsive to your needs. It should take you less than five minutes to complete this survey. You will remain anonymous. This survey is to be mailed in the enclosed postage-paid envelope directly to the researchers. The physicians and staff will NOT see the results of your survey. Thank you for taking the time to help us improve.
PLEASE CIRCLE THE NUMBER THAT BEST EXPRESSES YOUR LEVEL OF AGREEMENT OR DISAGREEMENT WITH THE FOLLOWING STATEMENTS.
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|
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AGREE |
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DISAGREE |
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1. |
My office appointment was available within a reasonable amount of time for my symptoms
|
10 |
9 |
8 |
7 |
6 |
5 |
4 |
3 |
2 |
1 |
N/A |
|
2. |
My telephone call was handled in a helpful manner
|
10 |
9 |
8 |
7 |
6 |
5 |
4 |
3 |
2 |
1 |
N/A |
|
3. |
The person at the check-in counter attended to me promptly |
10 |
9 |
8 |
7 |
6 |
5 |
4 |
3 |
2 |
1 |
|
|
4. |
The person who greeted me was friendly and courteous
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10 |
9 |
8 |
7 |
6 |
5 |
4 |
3 |
2 |
1 |
|
|
5. |
The nurse who showed me to the exam room was friendly and courteous
|
10 |
9 |
8 |
7 |
6 |
5 |
4 |
3 |
2 |
1 |
|
|
6. |
The person who handled my health insurance was helpful
|
10 |
9 |
8 |
7 |
6 |
5 |
4 |
3 |
2 |
1 |
N/A |
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7. |
If I called the Professional Urologists with medical questions, the answer was provided
|
10 |
9 |
8 |
7 |
6 |
5 |
4 |
3 |
2 |
1 |
N/A |
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8. |
If my phone call needed to be returned by the medical staff , it was done in a timely manner
|
10 |
9 |
8 |
7 |
6 |
5 |
4 |
3 |
2 |
1 |
N/A |
|
9. |
Overall I was pleased with the service of the Professional Urologists |
10 |
9 |
8 |
7 |
6 |
5 |
4 |
3 |
2 |
1 |
10. Would you like information on natural supplements as part of your treatment plan?
____Yes ____No
11. What is your health care insurance carrier? ________________________________________________
12. Are you satisfied with your health care insurance?
____Yes ____No
13. Was your healthcare information handled in a confidential manner?
____Yes ____No
PLEASE TURN TO THE BACK SIDE OF THIS PAGE
14. If Professional Urologists provided a web page on the Internet, would you be likely to use it?
____Yes ____No
15. Which of the following best expresses your preference regarding telephone calls to Professional Urologists?
__ I prefer speaking to a person
__ I prefer using the automated phone system to direct my call
16. My telephone calls to Professional Urologists were answered the same day
___Always ___Usually ___Seldom ___Never
17. Was this your first appointment with Professional Urologists?
____Yes ____No
18. Was this appointment a referral from your family doctor?
____Yes ____No
19. Was this appointment a follow-up visit from a procedure or surgery performed by Professional Urologists?
____Yes ____No
20. How long did it take to schedule your surgery?
___I did not need surgery ___1 wk or less ____2-3 wks ____4-5 wks ____6wks or more
21. How long did it take for you to get an appointment with Professional Urologists?
___1 wk or less ____2-3 wks ____4-5 wks ____6wks or more
22. What is an acceptable length of time to wait for an appointment?
___1 wk or less ____2-3 wks ____4-5 wks ____6wks or more
23. If you had to wait past your appointment time, how long were you in a waiting area?
___ I did not have to wait past my appointment time ___less than 15 min ____15-30 min ____31-45 min ____46-60 min ____more than 60 min
24. What is an acceptable period to spend in a waiting area?
___less than 15 min ____15-30 min ____31-45 min ____46-60 min ____more than 60 min
25. How long did you wait in the exam room for the physician?
___less than 10 min ___10-15 min ____16-20 min ____21-30 min ____31-40 min ___more than 40 min
26. What is an acceptable waiting time in the exam room?
___less than 10 min ___10-15 min ____16-20 min ____21-30 min ____31-40 min ___more than 40 min
27. Circle the name of the doctor you saw today.
Dr. A Dr. C Dr. E Dr. G Dr. I Dr. K
Dr. B Dr. D Dr. F Dr. H Dr. J Dr. L Dr. M
I did not see a doctor, I saw a nurse
28. Were you aware of the fact that the office you visited is part of a 13-doctor, 5-office practice called Professional Urologists?
___Yes ___No
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Thank you for your help. This survey is to be mailed in the enclosed postage-paid envelope directly to the researchers.
