Texas Ear, Nose & Throat Specialists               Patient Satisfaction Survey
Please take a few minutes to fill out this survey on the quality of service you received before and during your visit.  Your answers will be kept confidential.
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Office Staff were helpful and treated you with courtesy and respect?
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Promptness of phone call-back from our office during working hours
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Promptness of phone call-back from on-call doctor after hours
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The ease of your call being answered by a staff person when you called for an appointment or other service
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Satisfaction with the length of time between the day the appointment was made and the day of the visit
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Overall satisfaction with your wait time from time of arrival until seen by a doctor
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Did the provider spend enough time with you?
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Did the provider explain things in a way that was easy to understand?
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Did the provider listen carefully to you?
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Did the provider give you easy to understand information about your health questions or concerns?
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Did the provider seem to know important information about your medical history?
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Did the provider show respect for what you had to say?
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Using any number from 10 to 0, where 0 is the worst provider possible and 10 is the best provider possible, what number would you use to rate this provider? (10 to 0)
Worst provider possible
Best provider possible
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Overall satisfaction with your most recent visit
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Overall satisfaction with surgery scheduling and quotes
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Overall satisfaction with place of surgery (i.e. surgery center, hospital)
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Likelihood of recommending this practice to others
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Convenience of office hours
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Which location were you seen?
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Which provider did you see?
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Please provide any additional comments or suggestions to allow us to assist you better.
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