Patient Satisfaction Survey

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At Bethany Medical Center, "Your Health is our Concern" and our top priority. We would like to know more about your visit. Please help us to improve by filling out a very short survey. It takes less than 3 minutes!
Your responses are directly responsible for improving services offered. All responses will be kept confidential and anonymous. Thank you for your time.

To be entered in our monthly drawing for $100, please provide your name, email address, and phone number.

Your Name

(Please complete if you would like to be entered in our monthly prize drawing)

Email Address

(Please complete if you would like to be entered in our monthly prize drawing)

Phone Number

(Please complete if you would like to be entered in our monthly prize drawing)

Age

Please note that this question is optional and you are not required to answer. However, your feedback helps us to improve.

Gender

Please note that this question is optional and you are not required to answer. However, your feedback helps us to improve.

Please select your provider from the list below *

All responses will be kept confidential and anonymous unless you specify otherwise.

Henry Althisar, PA-C

Mark Arvind, MD

Wayne Beauford, MD

Douglas Blevins, MD

Don Bulla, PA-C

Krish Chinnasamy, MD

Mike Duran, PA-C

Jerry Edwards, FNP-C

Mike Kreitz Jr, PA-C

Ryan Miller, PA-C

John Mitchell, MD

Dorothy Norwood, MD

Priya Paruchuri, MD

Vamsee Paruchuri, MD

Lenny Peters, MD

Raymond Rosario, MD

Stephanie Samuelson, FNP-C

Fernando Sanchez-Brugal, MD

Karla Smith, MD

Yun Sun, MD

James Szabo, MD

Amanda Taylor, PA-C

Patrick Watterson, PA-C

Anthony Wheeler, MD

Did our operator answer your call promptly?

Strongly Disagree

Strongly Agree

Clear selection

Was our front office staff friendly, prompt, and helpful at check in?

Strongly Disagree

Strongly Agree

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Did your nurse provide friendly, prompt, and quality services and communications?

Strongly Disagree

Strongly Agree

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Did your provider meet your expectations?

Strongly Disagree

Strongly Agree

Clear selection

Would you recommend Bethany Medical Center to your family and friends?

Strongly Disagree

Strongly Agree

Clear selection

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