Please take a few minutes to fill out this survey on the timeliness and quality of the service you received today. Orthopaedic Specialists of Connecticut welcomes your feedback and your answers will be kept confidential. Thank you for your participation.
When you scheduled an appointment, did you have to wait longer than expected for an appointment? Yes No
How would you prefer to give personal and insurance information? Prefer Phone Would have preferred filling out paperwork myself Fill out on our website
Approximately how long did you wait on hold to speak to a scheduling staff member? 0 to 2 minutes 3 to 5 minutes 5 to 7 minutes Longer
How would you rate the disposition of the person who scheduled your appointment? Attentive Concerned Friendly Distracted Rushed Rude
How would you rate the staff’s disposition at the reception desk? Attentive Concerned Friendly Distracted Rushed Rude
How long did you wait in the reception area beyond your scheduled appointment time? 0 to 5 minutes 5 to 10 minutes 10 to 20 minutes Other:
How would you rate our concern for your privacy? Outstanding Good Adequate Needs Improvement Poor If you checked: Needs Improvement or Poor, please explain below:
Which Provider did you see today? Dr. Nipper Dr. Diaz Dr. Fish Dr. Gupta William Broadhurst, PA-C Ana Cario, PT Meg Fesh, PT Pam Lehman, PT
Did you feel that your Provider spent an adequate amount of time with you? Yes No
Did you feel that your Provider’s examination was thorough? Yes No
Mark the boxes that characterize the demeanor of your Provider: Attentive Concerned Friendly Distracted Rushed Inconsiderate
Were your questions answered to your satisfaction regarding your condition and/or treatment options? Yes No
Would you recommend this facility and its staff to your family and friends? Yes No
Please list any areas in which our service could be improved, along with any additional comments.
Patient Name: (optional)
Thank you for taking the time to fill out our survey. We rely on your feedback to help us improve our services. Your input is greatly appreciated!
