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Pain
Talk about pain pump
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Dr. Provenzano
Hilary Trenz- Physician Assistant
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1.
Excellent
2.
Above Average
3.
Average
4.
Below Average
5.
Poor
6.
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1.
Excellent
2.
Above Average
3.
Average
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Below Average
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Poor
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1.
Exceeds Expectation
2.
Meets Expectations
3.
Neutral
4.
Does not meet Expectations
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Strongly does not meet expectations
6.
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1.
Exceeds Expectations
2.
Meets Expectations
3.
Neutral
4.
Does not meet expectations
5.
Strongly does not meet Expectations
6.
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1.
Strongly Agree
2.
Agree
3.
Neutral
4.
Disagree
5.
Strongly Disagree
6.
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1.
Strongly Agree
2.
Agree
3.
Neutral
4.
Disagree
5.
Strongly Disagree
6.
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1.
Strongly Agree
2.
Agree
3.
Neutral
4.
Disagree
5.
Strongly Disagree
6.
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1.
Extremely Likely
2.
Likely
3.
Neutral
4.
Unlikely
5.
I would not return
6.
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1.
Exceeds Expectations
2.
Meets Expectations
3.
Neutral
4.
Does not meet Expectations
5.
Strongly does not meet Expectations
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No
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Message for respondents
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Insights
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What was the reason for today's visit?
No responses yet for this question.
How long did you wait in the waiting room and exam room before you were seen today?
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Was this your first visit to Pain Diagnostics and Interventional Care? If yes, how long did you wait from the time of call to your appointment today?
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Which Provider were you seen by today?
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How would you describe the ease of making an appointment for today's visit?
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How would you describe the registration process for today's visit?
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How would you describe the friendliness and helpfulness of the office staff?
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How would you describe the waiting room atmosphere and exam room privacy?
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Did you feel that your diagnosis and treatment plan was discussed with you at an appropriate level of understanding by the provider?
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Did the provider spend enough time with you at your office appointment?
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If you called our office with questions or concerns, did you feel that answers were provided to you and that you received appropriate follow-up?
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What is the likelihood that you would return to Pain Diagnostics and Interventional Care, if needed, in the future?
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How would you rate your overall experience at Pain Diagnostics and Interventional Care?
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If we did not meet expectations for today's visit, please share why.
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Additional Comments
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Name (Optional)
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Do you wish to be contacted?
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