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Houston Clear Lake League City Friendswood Webster Seabrook Texas City Kemah Dickinson Galveston Pearland Katy Alvin Angleton Missouri City Santa Fe Dr Willie Zoma MD Gynecologist Fertility expert Infertility evaluation In vitro fertilization IVF Surrogate motherhood Recurrent pregnancy loss Menstrual irregularities Abnormal uterine bleeding Uterine fibroids Premature ovarian failure Menopause Osteoporosis Endometriosis Birth control Hysteroscopy Laparoscopy Myomectomy Tubal litigation reversal Intracytoplasmic Sperm Injection ICSI Pelvic ultrasound Sonohysterography SHG Hysterosalpingogram HSG
     
 

Welcome to our practice. You are very important to us, and we value your opinions and comments regarding our medical office. A moment of your time is requested to answer the following questions about your visit today and return it in the box in the reception area or to mail it back to us in the envelope provided. Your comments will assist us in continuing to provide the highest quality of medical care available.

A scale of 5 (being most satisfied) to 1 (being least satisfied) has been provided to rate your experience with us today. For those items that are not applicable, select NA.

1. When I telephoned to make an appointment, I was greeted with courtesy and respect.
2. I was assisted in finding a suitable appointment time.
3. When I telephoned for my appointment, I did not have to remain on hold for longer than three minutes before I spoke to a staff member.
4. I received adequate instructions on to how to find the office.
5. The reception area is neat and comfortable.
6. There is adequate seating available.
7. There is current and interesting material to read.
8. I was greeted when I arrived and the staff explained office policies and procedures in clear, easy-to-understand terms.
9. Confidential conversations were not audible from the reception area.
10. The staff demonstrated their respect for me by not calling me by my first name.
11. Each staff member has a neat, professional appearance.
12. The staff members were able to answer my questions
13. The staff member who escorted me to the treatment area was cordial and professional in manner.
14. When my doctor greeted me he made me feel important.
15. My doctor explained what he was doing while he was examining me.
16. The procedure for receiving a laboratory test or diagnostic report was explained to me and easy to understand.
17. The office's procedures for billing were clearly explained to me.
18. I was given the opportunity to schedule my next visit before I left.
19. I would tell someone else about the positive experience I had today.
20. I would refer a friend or relative to this practice.

 

 

 
     
 
 
   
   
 
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