Patient Satisfaction Survey

Patient Survey Form
Office Location
Is this your first visit to the practice?

Access To Care

Ease of scheduling your appointment
Courtesy of call nurse, if you spoke with one
Courtesy of person who scheduled your appointment

During Your Visit

Courtesy of Staff in the Registration Area
Atmosphere & Level of Comfort in the Waiting Area
Length of Wait Before Going to an Exam Room
Comfort & Pleasantness in the Exam Room
Friendliness / Courtesy of the Nurse / Assistant
Waiting Time in the Exam Room Before Being Seen by the Provider

Your Care Provider

Friendliness / Courtesy of the Care Provider
Amount of Time the Care Provider Spent With You
Your Confidence in this Care Provider
Likelihood of Your Recommending this Care Provider to Others

Our Facility

Hours of Operation Convenient for You
Overall Comfort of Your Visits
Adequate Parking
Signage & Directions Easy to Follow

Overall Assessment

Our Sensitivity to Your Needs
Overall Cheerfulness of Our Practice
Overall Cleanliness of Our Practice
Overall Rating of Care Received During Your Visit
Likelihood of Your Recommending Our Practice to Others

Attention Patients: Use My Lahey Chart to request RX refills. Use this link to My Lahey Chart.