302.855.1233

Patient Satisfaction Survey
We would like to know how you feel about the services we provide so we can make sure we are meeting your needs. Your responses are directly responsible for improving these services. All responses will be kept confidential and anonymous. Thank you for your time.
LOCATION
Georgetown Seaford Milford
PROVIDERS:
Family Practice
Dr Fabricio Alarcon
Dr. Amudha Boopathi
Dr. Marisel Santiago
Dr. Seema Tayal,
Anne Caswell, Family Nurse Practitioner
Nadya Julien, Certified Nurse Practitioner
Gloria Lester EdD, MSN, CRNP
Behavior Health
Sue Bardsley, Psychiatric Nurse Practitioner
P. Yvonne Dodd, Licensed Clinical Social Worker
Michael Thornsberry, Licensed Clinical Social Worker
Cathy O'Neill, Licensed Clinical Social Worker
Jesus Santana, Licensed Clinical Social Worker
Prenatal
Dr. Ian Baxter
Dr. Abha Gupta
Coleen Brogan, Certified Nurse Midwife
Dental Services
Dr. Maryann Bailey
Amy Coy, Hygienist
Kelly Russell, Hygienist
HIV/STD Counselor
Angel Rivera
CHAP/SFL Coordinator
Denise Torres
Marketplace CAC
Areli Garrido
Derling Salazer
  Date of visit:
DEMOGRAPHICS
AGE
18-24
25-34
35-44
45-54
55+

SEX
Male
Female

RACE
Asian
Pacific Islander
Black/African American
American Indian/Alaska Native
White (Not Hispanic or Latino)

Hispanic or Latino (All Races)
Unknown
 

ACCESS TO CARE:
When you called to schedule an appointment, how soon did you receive an appointment?
Walk-in
1-7 days
8-14 days
15-21 days
22-28 days
29 days or more

FRONT STAFF
Appearance and professionalism
  N/A  
  Poor  
  Fair  
  Good  
  Great 
Courtesy and helpfulness
  N/A  
  Poor  
  Fair  
  Good  
  Great 
Greeting received
  N/A  
  Poor  
  Fair  
  Good  
  Great 
Privacy respected
  N/A  
  Poor  
  Fair  
  Good  
  Great 

WAITING
Time in waiting room
  N/A  
  Poor  
  Fair  
  Good  
  Great 
Time in exam room
  N/A  
  Poor  
  Fair  
  Good  
  Great 
Waiting for return phone calls
  N/A  
  Poor  
  Fair  
  Good  
  Great 
Waiting for test result
  N/A  
  Poor  
  Fair  
  Good  
  Great 

PROVIDER
Listens carefully to what I have to say
  N/A  
  Poor  
  Fair  
  Good  
  Great 
Time spent with you
  N/A  
  Poor  
  Fair  
  Good  
  Great 
Explanation the provider gave you about your problem
  N/A  
  Poor  
  Fair  
  Good  
  Great 
Treats me in a very friendly and courteous manner
  N/A  
  Poor  
  Fair  
  Good  
  Great 

NURSES AND MEDICAL ASSISTANTS
Friendly and helpful to you
  N/A  
  Poor  
  Fair  
  Good  
  Great 
Answers your questions
  N/A  
  Poor  
  Fair  
  Good  
  Great 

HIV COUNSELORS, PROMOTORAS, CHAP COORDINATORS
Friendly and helpful to you
  N/A  
  Poor  
  Fair  
  Good  
  Great 
Answers your questions
  N/A  
  Poor  
  Fair  
  Good  
  Great 

BILLING
Friendly and courteous
  N/A  
  Poor  
  Fair  
  Good  
  Great 
Explanation of charges
  N/A  
  Poor  
  Fair  
  Good  
  Great 
Helpfulness in resolving issue
  N/A  
  Poor  
  Fair  
  Good  
  Great 

INTERPRETER
Friendly and helpful to you
  N/A  
  Poor  
  Fair  
  Good  
  Great 

FACILITY: ORDERLINESS AND CLEANLINESS
Building
  N/A  
  Poor  
  Fair  
  Good  
  Great 
Reception area
  N/A  
  Poor  
  Fair  
  Good  
  Great 
Bathrooms
  N/A  
  Poor  
  Fair  
  Good  
  Great 
Exam rooms
  N/A  
  Poor  
  Fair  
  Good  
  Great 

OVERALL
How satisfied are you?
  N/A  
  Poor  
  Fair  
  Good  
  Great 

SELF CARE MANAGEMENT SUPPORT
Did you receive or were you offered a clinical summary when you were discharged?
Agree
Disagree
N/A
Did you receive information to help manage your care?
Agree
Disagree
N/A

CARE COORDINATION
If you were given a referral, was your appointment made at the time of check out?
Agree
Disagree
N/A

PATIENT STATUS
Are you a new patient or an established patient?

RECOMMENDATIONS
Would you recommend us to others?
Agree
Disagree
N/A

Please tell us in your own words:
What do you like best about our center?
What do you like least about our center?
Do you have any suggestions on how we could improve our services?


Type the letters and numbers
from the image above:

You may reset the image here
   


RETURN
 
 
VIEW EXTENDED SITE MAP