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Patient Feedback
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
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PGO Patient Feedback
1
How easy was it to schedule an appointment with our facility?
Select one or more answers
EXTREMELY EASY
SOMEWHAT EASY
NOT EASY AT ALL
2
How satisfied are you with the receptionist staff?
0
Unsatisfied
Very Satisfied
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3
If you were not satisfied with the receptionist staff, can you please share your experience so that we can address these concerns?
4
Where you satisfied with the physician and/or therapist who provided you with services?
0
Unsatisfied
Very Satisfied
Ok
5
If you were not satisfied with the physicians and/or therapists, can you please share your experience so that we can address these concerns?
6
Would you recommend our office to your family and friends
Select one answer
Yes
Unsure
No
7
How long have you been a patient with our facility?
Select one answer
New Patient
1-6 months
7-12 months
1-3 years
>3 years
8
How would you rate your overall experience with the Psychiatric Group of Orlando?
0
Very Poor
Excellent
Ok
9
We would appreciate any additional feedback or comments you have about your experience with our facility.
10
This is an anonymous feedback form; however, if you feel comfortable providing your contact information, please do so by entering it below so that we can reach out to you for follow-up and to ensure that your concerns were timely and appropriately addressed.
This is completely optional. If you opt to do this, please provide your full name, phone number, and email and note your preferred contact method.
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