Patient Satisfaction Survey

If you would like to give us feedback about how well we have accomplished our practice vision, or have any other comments, please left click and highlight the Patient Satisfaction Survey below, print it off, fill it out, and mail it to Dr. Miller at 320 Cool Water Court, Hopkinsville, KY  42240.  You may also phone our office at Hopkinsville Office Phone Number 270-885-0165 and ask to speak to Dr. Miller directly. 

 

 

PATIENT SATISFACTION SURVEY FOR MARK D. MILLER, DDS, PSC 

 

Thank you for choosing us for your oral and maxillofacial surgical care.  Our goal is to make you as comfortable as possible while providing the highest quality of care.  In order to help us achieve this goal, will you please answer the questions in this survey about your experience in our office and during your recovery?  Dr. Miller will be the first one to read this survey.

 

Was your receptionist was Melita or Brittaney  (Please circle who helped you.)

During your care in our office, how often did your receptionist treat you with courtesy and respect?

     [   ] Always          [   ] Usually          [   ] Sometimes          [   ] Never

During your care in our office, how often did your receptionist listen to you carefully?

     [   ] Always          [   ] Usually          [   ] Sometimes          [   ] Never

During your care in our office, how often did your receptionist explain things to you in a way your could understand?

     [   ] Always          [   ] Usually          [   ] Sometimes          [   ] Never

 

Was your surgical technician Trina or Sara?  (Please circle who helped you.)

During your care in our office, how often did your surgical technician treat you with courtesy and respect?

     [   ] Always          [   ] Usually          [   ] Sometimes          [   ] Never

During your care in our office, how often did your surgical technician listen to you carefully?

     [   ] Always          [   ] Usually          [   ] Sometimes          [   ] Never

During your care in our office, how often did your surgical technician explain things to you in a way your could understand?

     [   ] Always          [   ] Usually          [   ] Sometimes          [   ] Never

 

During your care in our office, how often did Dr. Miller treat you with courtesy and respect?

     [   ] Always          [   ] Usually          [   ] Sometimes          [   ] Never

During your care in our office, how often did Dr. Miller listen to you carefully?

     [   ] Always          [   ] Usually          [   ] Sometimes          [   ] Never

During your care in our office, how often did Dr. Miller explain things to you in a way your could understand?

     [   ] Always          [   ] Usually          [   ] Sometimes          [   ] Never

 

How comfortable were you during your surgery?

     [   ] Very comfortable          [   ] Somewhat comfortable          [   ] Somewhat uncomfortable          [   ] Very uncomfortable

What could we have done to make you more comfortable?

  

 

 

How comfortable were you during your recovery from surgery?

    [   ] Very comfortable          [   ] Somewhat comfortable          [   ] Somewhat uncomfortable          [   ] Very uncomfortable

What could we have done to make you  more comfortable?

 

 

 

 

If you had any questions or problems after surgery how satisfied are you with the help you received?

     [   ] Very Satisfied          [   ] Somewhat satisfied          [   ] Somewhat unsatisfied          [   ] Very unsatisfied

What could we have done to help you better?

 

  

 

How satisfied are you with the handling of your finances / insurance claim?

     [   ] Very Satisfied          [   ] Somewhat satisfied          [   ] Somewhat unsatisfied          [   ] Very unsatisfied

 

How satisfied were you with the cleanliness of our office? 

     [   ] Very Satisfied          [   ] Somewhat satisfied          [   ] Somewhat unsatisfied          [   ] Very unsatisfied

 

If you were helped by our answering service, how satisfied were you with their help?

     [   ] Very Satisfied          [   ] Somewhat satisfied          [   ] Somewhat unsatisfied          [   ] Very unsatisfied

 

Is there anything else you would like to share with us?

 

 

 

 

 

May we share your comments with others?     [   ] Yes          [   ] No

 

Patient’s Name (optional):

 

Thank you for helping us to take better care of our patients!