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HSWL RP Kodiak
Rockmore-King Clinic
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ROCKMORE-KING CLINIC PATIENT SATISFACTION SURVEY
HSWL RP Kodiak
What is three plus one?
Do not enter:
Are you active duty, a dependent or a retiree?
Active Duty
Dependent
Retiree
Please choose the purpose of your visit today from the dropdown menu.
Medical
Dental
Pharmacy
Lab
X-ray
Immunizations
Physical Exams
Physical Therapy
Optometry
Administration
Off Island Care
TriWest
1. When you made your appointment for this visit, did you get an appointment as soon as you thought you needed it?
Definitely Yes
Definitely No
Somewhat Yes
Somewhat No
N/A Skip to #4
2. How easy was it for you to schedule an appointment?
Extremely Easy
Easy
Not Easy
Difficult
3. When you called to schedule an appointment, did the scheduling staff treat you with courtesy and respect?
Definitely Yes
Definitely No
Somewhat Yes
Somewhat No
4. Did you find our hours of operation convenient in meeting your healthcare needs?
Definitely Yes
Definitely No
Somewhat Yes
Somewhat No
5. During your visit, were you kept informed about how long you would need to wait for your appointment to start?
Yes
No
6. How long did you wait in the waiting room before being escorted to the exam room?
0-15 minutes
15-30 minutes
30-45 minutes
45-60 minutes
7. How long did you wait in the exam room before being seen by the provider or having your concern otherwise addressed?
0-15 minutes
15-30 minutes
30-45 minutes
45-60 minutes
8. During your visit, did clerks and receptionists at the clinic treat you with courtesy and respect?
Definitely Yes
Definitely No
Somewhat Yes
Somewhat No
9. During your visit, were the clerks and receptionists at the clinic as helpful as you thought they should be?
Definitely Yes
Definitely No
Somewhat Yes
Somewhat No
10. During your visit, was the check-in process completed in a timely manner?
Yes
No
11. When you called the clinic during regular office hours, did you get an answer to your questions that same day?
Definitely Yes
Definitely No
Somewhat Yes
Somewhat No
12. During your visit, did nurses and Health Services Technicians treat you with courtesy and respect?
Definitely Yes
Definitely No
Somewhat Yes
Somewhat No
13. During your visit, were the nurses and Health Services Technicians as helpful as you thought they should be?
Definitely Yes
Definitely No
Somewhat Yes
Somewhat No
14. When you are sent for a blood test, x-ray or other test, does someone from the clinic follow up to give you the test results?
Definitely Yes
Definitely No
Somewhat Yes
Somewhat No
I wasn't sent for any tests
15. During your visit, did the provider treat you with courtesy and respect?
Definitely Yes
Definitely No
Somewhat Yes
Somewhat No
16. During your visit, did the provider explain things in a way that was easy to understand?
Definitely Yes
Definitely No
Somewhat Yes
Somewhat No
17. During your visit, did the provider show concern about your health and how you were feeling?
Definitely Yes
Definitely No
Somewhat Yes
Somewhat No
18. During your visit, did the provider spend enough time with you?
Definitely Yes
Definitely No
Somewhat Yes
Somewhat No
19. During your visit, did the provider seem to know important information about your medical history?
Definitely Yes
Definitely No
Somewhat Yes
Somewhat No
20. During your visit, did the provider talk with you about the pros and cons of each choice for your treatment or health care?
Definitely Yes
Definitely No
Somewhat Yes
Somewhat No
21. If needed, was it easy to get an appointment with a specialist?
Never
Sometimes
Usually
Always
Not Applicable
22. If you needed to see a specialist, how often were you notified that the authorization was approved?
Never
Sometimes
Usually
Always
Not Applicable
Using any number from 0 to 10, where 0 is the worst care possible and 10 is the best care possible, what number would you use to rate the care you received during your visit today?
10 Best Care Possible
9
8
7
6
5
4
3
2
1
0 Worst Care Possible
24. Would you recommend this clinic to your family and friends?
Definitely Yes
Definitely No
Somewhat Yes
Somewhat No
We welcome additional comments or suggestions:
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Last Modified 8/8/2012