1. |
Please indicate the type of treatment you had (for example,
IUI, IVF, Frozen Embryo Transfer, Medications, Surgery, Donor Oocytes, and so
on): *
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Please answer the following by choosing a rating from the dropdowns to the right of questions 2-14:
N/A=not applicable | 1=very dissatisfied | 2=somewhat dissatisfied | 3=neutral | 4=satisfied | 5= very satisfied |
2. |
I was able to schedule my appointment within a reasonable time period.
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3. |
The appointment scheduler was pleasant and courteous.
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4. |
The telephone service was efficient and met my needs.
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5. |
My check-in was handled courteously and efficiently.
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6. |
My wait in the reception area was comfortable.
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7. |
My physician treated me in a courteous, attentive and helpful
manner.
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8. |
The other clinical staff treated me in a courteous, attentive
and helpful manner.
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9. |
The laboratory staff treated me in a courteous, attentive and helpful manner.
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10. |
My treatment was explained to my satisfaction.
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11. |
My questions were answered to my satisfaction.
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12. |
My check-out and payment was handled courteously and efficiently.
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13. |
The treatment fee/billing information I received was clear and correct.
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14. |
The care I received from the mind-body program met my expectations.
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15. |
Was there anyone on the staff who gave you exceptional service?
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16. |
Your comments and suggestions are most welcome:
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Date of Service: *
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Location of Service: *
Palo Alto Office
San Jose Office
Other |
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Name (optional):
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Please contact me directly if I can be of service,
Linton White
Chief Operating Oficer
408.356.5000
Thank you for your comments. |
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