Patient Survey – Office

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


Who is your appointment with today?


When you scheduled your appointment, did you have to wait longer than expected to be seen?
YesNo

How easy was it to make an appointment by telephone?


How long did you wait to speak to a scheduling staff member?


Was the person who scheduled your appointment courteous and helpful?


How would you rate the courtesy and competence of the staff at the reception desk/check-in staff?


How woulod you rate the courtesy and competence of the staff at the check-out desk?


How would you rate the courtesy and competence of the nurse/medical assistant who roomed you?


How would you rate the courtesy and competence of the lab technician who assisted you?


Was the lab technician that assisted you a HealthCore or LabCorp employee?
HealthCore (wears blue top and black pants)LabCorp (does not wear HealthCore uniform)

How easy was it to reach your nurse's voicemail?


How long did you wait for your nurse to return your call?


Was the nurse who returned your call courteous and helpful?


How would you rate the competence of the nurse who helped you?


How would you characterize the concern the nurse showed for your problem?


Would you recommend this facility and its staff to your family and friends?


Please list any areas in which our service could be improved.


Please share any additional comments.


Would you like someone to contact you regarding your responses on this survey?
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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