Patient Survey – Lab

This survey will remain anonymous unless you wish to replace the First Name, Last Name, and Email with your own information.

IF YOU ARE EXPERIENCING A MEDICAL EMERGENCY, CALL 911.

MEDICAL QUESTIONS/INFORMATION, APPOINTMENT REQUESTS, SYMPTOM NOTIFICATIONS, ETC.

SHOULD NOT BE SUBMITTED THROUGH THIS WEBSITE.

This website feature is for feedback purposes & general inquiries only. Correspondence may not be processed daily, and is not reviewed after business hours or on the weekends.

For any non-emergency medical needs or questions please contact the office directly at 972-284-7000972-284-7000. Thank you.

* Required

    Title


    First Name *

    Last Name *

    Email Address *

    Is this the first time you have had medical tests completed at this laboratory?
    YesNo

    Did you also have an office visit with your physician or the nurse practitioner today?
    YesNo - this was a lab only visit

    Were you assisted by a HealthCore lab technician or a LapCorp Technician? (HealthCore technicians wear the blue/black scrub uniform similar to that which your nurse wears).
    HealthCoreLapCorpUnknown

    Did the lab technician introduce him/herself?
    YesNo

    How long of a wait did you experience?
    Less than 5 minutes5-10 minutes10-20 minutesOver 20 minutes

    If you experienced a wait time of over 10 minutes, was the purpose/reason for the wait explained to you?
    YesNoN/A

    Was the cleanliness of the Lab acceptable?
    YesNo

    Were you treated with courtesy and respect?
    YesNo

    Would you recommend our lab services to others?
    YesNo

    I hereby acknowledge that this form is unencrypted and not a secure means of electronic communication with, HealthCore Physicians Group, my healthcare provider or facility. I agree to allow HealthCore Physicians Group or facility staff to reply to the email address indicated on this form, and to forward or share the information contained in this form, including any Personal Health Information (PHI), with other health professionals or associated staff using non-secure electronic communication methods such as email.

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