"Helping you on your road to good health." 

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. (Please rate based on the following: 5=Great; 4=Good; 3=Okay; 2=Fair; 1=Poor)


Your Race/Ethnicity

--Ease of getting care--



--Nurses and Medical Assistants--

--Other Staff Members--