PATIENT SATISFACTION SURVEY

Thank you for taking the time to provide us feedback. We appreciate it!

(Muchas gracias por darnos su opinión. Esto nos ayudará a proveerle un mejor servicio en el futuro.)

First and Last Name*

(Nombre y Apellido)

First Last

Which of Our Offices Did You Most Recently Visit?*

(¿Cuál de nuestras Oficinas Ud. visitó recientemente?)

Which South Tampa Physician Did You See?*

(¿Que Doctora la vio?)

Which North Tampa Physician Did You See?*

(¿Que Doctora la vio?)

Which Lutz Physician Did You See?*

(¿Que Doctora la vio?)

Which Riverview Physician Did You See?*

(¿Que Doctora la vio?)

Please rate your experiences with us below from 1 to 5 stars:

(Use de 1 a 5 estrellas para darnos su opinión sobre cada asunto: 5 estrellas es excelente y 1 estrella indica que necesita mejora.) Ratings by stars: 5 stars= Excellent, 4 stars= Pretty Good, 3 stars= Neutral, 2 stars= Not So Great, 1 star= Needs Improvement

How Would You Rate Your Patient Experience with Your Physician?*

(¿Cómo juzga su interacción con su doctora?)

How Would You Rate the Professionalism of Our Office Support Staff, including your check-in and check-out?*

(¿Cómo juzga el profesionalismo del resto del personal en nuestra oficina, incluyendo el personal de registración y de salida?)

How Would You Rate the Overall Cleanliness and Comfort of Our Office?*

(¿Cómo juzga la limpieza, decoración y conforte de nuestra oficina?)

Would You Recommend The Woman's Group to a Friend?*

(¿Le recomendaría Ud The Woman’s Group a una amiga?)

How Would You Rate Your Overall Experience at The Woman's Group?*

(¿Cómo juzga su experiencia total con The Woman’s Group?)

Good to Excellent (De buena a excelente)
Neutral
Not So Great or Needs Improvement (No tan bueno o necesita mejora)

Please share your comments about your visit with us here so that we may review your concerns and respond to you. We strive to provide great patient experiences and truly value your opinion. We will be getting in touch with you soon.

(Por favor denos sus comentarios sobre su visita de manera que podamos analizarlos, corregir lo que sea necesario y responderle. Nuestro mayor interés es proveer cuidado de alta calidad en todos los aspectos de su visita. Valoramos su opinión y estaremos en contacto con ud. pronto.)

Would you like to share any comments about your visit with us? We strive to provide great patient experiences and truly value your opinion.

(¿Le gustaría hacer algún comentario específico sobre su experiencia durante su visita? Nosotros valoramos grandemente su opinión.)

Name

This field is for validation purposes and should be left unchanged.

A quick, 5 question opportunity to tell us about your experiences with us

Thank you for taking the time to provide us feedback. We appreciate it!

Please rate your experiences with us below from 1 to 5 stars: