Patient Experience Survey
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 are kept confidential unless otherwise indicated and reported directly to our management team. 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)
Your answer
Email Address
(Please complete if you would like to be entered in our monthly prize drawing)
Your answer
Phone Number
(Please complete if you would like to be entered in our monthly prize drawing)
Your answer
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.
Did our operator answer your call promptly?
Strongly Disagree
Strongly Agree
Was our front office staff friendly, prompt, and helpful at check in?
Strongly Disagree
Strongly Agree
Did your nurse provide friendly, prompt, and quality services and communication?
Strongly Disagree
Strongly Agree
Did your provider meet your expectations?
Strongly Disagree
Strongly Agree
Would you recommend Bethany Medical Center to your family and friends?
Strongly Disagree
Strongly Agree
Comments
Please write any additional comments or suggestions for improvement below.
Your answer
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