ISLETA HEALTH CENTER  Patient Satisfaction Survey
We would like to know how you feel about the services we provide so we can make sure we are meeting your needs.  Your responses are directly responsible for improving these services.  All responses will be kept confidential and anonymous.  Thank you for your time.

If any questions please contact Quality Improvement Coordinator: Dominic Trujillo at 505-869-4468 or dominic.trujillo@islclinic.net
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Please answer questions below *
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
N/A
An appointment was available when I needed it
When I arrived for my visit, I did not have to wait more than 20 minutes past my scheduled appointment to be seen
The clinic staff was courteous
I have trust in the clinical staff
The clinic was clean
The provider listened carefully
I received enough time from my provider
I was provided with enough information to make decisions
I was given the chance to provide input into decisions about my care
I observed the provider washing/sanitizing their hands before and after examining me
My culture and traditions were respected
Ease of ability to obtain prescriptions/refills
Medications were explained to me in a way that was easy to understand
If a referral was needed from PRC, it was easily provided
If transportation was provided by CHR, my driver was courteous and professional
If at the Diabetes Wellness Center, my trainer was courteous and professional
If at Physical Therapy, my therapist was courteous and professional
Overall, I am satisfied with my visit
Where was your appointment? *
Date of Service *
MM
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DD
/
YYYY
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