Memphis Gastroenterology Group P.C.

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Memphis Gastroenterology Group, P.C.

Patient Survey

At Memphis Gastroenterology Group, P. C. (MCG), our goal is to provide comfort, convenience, and satisfaction to all our patients. We need your opinions and comments to tell us how well you are satisfied. Please take a few minutes to complete this questionnaire and submit it at the end of the survey. All information is confidential.

If you mark any answers negatively, we would especially appreciate additional comments regarding your concerns. All responses are anonymous, so please take this opportunity to respond freely.

Thank you.

Survey

Age of Patient *

Sex of patient *

Patient's Name (this is optional)

What doctor have you seen? *

Overall, how would you evaluate health care at MGG? *

Convenience of location of the doctor's office? *

Hours when the doctor's office is open? *

Were you able to make an appointment easily and in a reasonable time period? *

When you called to make an appointment, was the office staff helpful and courteous? *

Length of time you waited between making an appointment for routine care and the day of your visit? *

Thoroughness of treatment? *

Explanations of medical procedures and tests? *

Attention given to what you had to say? *

Advice you received about ways to avoid illness and stay healthy? *

Friendliness and courtesy shown to you by doctors? *

Respect shown to you, attention to your privacy? *

Friendliness and courtesy shown to you by staff? *

Amount of time you have with doctors and staff during a visit? *

What factor (s) influenced your initial choice of our office ? (check all that apply) *
  Referred by another patient
  Referred by another doctor
  Referred by family member of friend
  Member of HMO, PPO, or other managed care plan
  Telephone Listing
  Close to home/business
  Other

If you selected "Other", please specify:

How long beyond your appointment time do you usually have to wait in the office to see your doctor? *

Would yo recommend MCG to your family or friends if they needed care? *

Which of the following best describes your racial or ethnic background? *

If you selected "Other", please specify:

What is the highest grade you completed in school? (Choose the selection that includes the highest grade you completed) *

What is the 5-digit zip code at your home address?

Could we have done anything to have made you feel more safe & secure?

Any additional comments you may wish to share with us?