Patient Feedback
Thank you for choosing the neuro well for your neuropsychiatry needs.  

We strive to provide you the most excellent, accessible, and compassionate care.  

We would appreciate your feedback so that we can review your answers and continue to improve.
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Who was your most recent provider? *
How long have you been a patient? *
How caring would you say the following individuals are?
 *
Extremely uncaring
Very uncaring
Caring
Very caring
Extremely caring
Your healthcare provider?
Our office staff?

For each item identified below, choose the option that best fits your judgment of its quality. 

 *
Poor
Fair
Good
Excellent
Ease of making appointments?
Waiting time for your appointment?
The time it takes someone from our office to respond?
How well did your provider listen to you?
How well did your provider make you feel at ease?
To what level do you believe your provider understood the nature of your problem?
How well did your provider explain all anticipated examinations, diagnosis, and treatment?
To what level did you feel part of the planning of the treatment process?
How well do you feel your provider maintained your confidentiality during and following your office visit?
How well do you feel your provider maintained appropriate professional boundaries during your office visit?
If you rated any service as 1 (Poor) or 2 (Fair), please explain: 
Have you had any interaction with your provider outside of the office? If yes, please explain
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This form was created inside of the neuro well.