Patient Satisfaction Survey

Please select the rating below each column.	Excellent	Very Good	Good	Fair	Poor	Very Poor	N/A
1.Ease of making appointments by phone:
2.Courtesy of the person who took your call
3.Efficiency of the check-in process
4.Waiting time in the reception area
5.Kept you informed if your appointment was delayed
6.Waiting time in the exam room
7.The courtesy of your physician
8.Courtesy and professionalism of the medical assistant
9.Explanation of the discharge instructions from the medical assistant
10.Efficient friendly manner of your procedure scheduling
11.Waiting time to check out
12.Timely response to your phone calls to the physician’s nurse
13.Courtesy and professionalism of the response from the Medical Records Department
14.Courtesy and professionalism of the response from the Billing Office
15.Would you recommend this practice to others?		Yes			No
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Our Locations:

3702 Timberline Rd, Bldg A
Fort Collins, CO 80525
ph-970-207-9773
Toll Free 1-877-713-7392
fax-970-207-1893
Office Hours: M-Th 7am-5pm
Fri 7am-3:30pm

2555 E 13th St
Suite 220
Loveland, CO 80537
ph-970-669-5432
fax-970-619-6275
Office Hours: M-F 8am-5pm

7251 W. 20th
Greeley, CO 80634
ph-970-378-1414
fax-970-378-1515
OfficeHours:M-F 8am-5pm

4108 Laramie St
Cheyenne, WY 82001
Toll Free
1-877-713-7392
Office days and hours vary, please contact (the 877 number for appointments)