Houston Specialty Clinic Patient Satisfaction Survey
Following your visit, please take some time to help us to improve. Stress the positives. Or, Offer constructive feedback so we can improve. This form is hosted on our, medical quality, protected Google site. Your responses are considered private. Please consult our office privacy practices for details.
Email address
Houston Speciality Clinic
May we use your feedback for educational, quality improvement or public awareness
Thank you for providing feedback. We welcome positive feedback and suggestions of how to improve. Any comments will not include identifying information.
With whom was your appointment?
What are the last 4 numbers of the RESPONSIBLE PARTY's phone? (this question is intended to verify your identity)
Your answer
What date were you last seen?
MM
/
DD
/
YYYY
How would you rate our phone center service?
One star
Five stars
How was your experience scheduling an appointment?
One star
Five stars
How would you rate our appointment reminder service
One Star
Five Stars
How was your experience with our front desk?
One Star
Five Stars
How willing are medical assistants to listen carefully to you?
:-(
:-)
What is your overall rating of care from your provider or nurse?
Needs Improvement
Wow!
Did your doctor / PA explain things is away that was easy to understand?
Did the doctor / PA listen carefully to you?
Did you talk with your doctor / PA about any health problems or concerns?
Did your doctor / PA give you easy to understand instructions about taking care of those health problems or concerns?
Did your doctor / PA seem to know the important information about your medical history?
Did your doctor / PA show respect for what you had to say?
Did your doctor / PA spend enough time with you?
How much time did your doctor / PA spend with you?
How much time did the medical assistant spend with you after the visit?
Compared to other specialist practices, tell us about YOUR OVERALL SATISFACTION WITH our practice.
One Star
Five Stars
Please provide feedback
Your praises and suggestions for improvement help! Give a shout out to someone who did a great job. Help us train and improve our service!
Your answer
How can we best contact you? (Please provide phone or email)
Your answer
I would like a call from a manager to resolve my issue.
Please call 7134644107 OR email clinicrotenberg at houstonspecialtyclinic DOT com OR contact us through our portal to get prompt response.
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