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Please take time to provide feedback concerning the level of Health   Care Southern Medical Group provided to you.


1.  Your communication with our:
A. Front desk receptionist
Satisfied
Dissatisfied
Not Applicable
B. Telephone receptionist
Satisfied
Dissatisfied
Not Applicable
C.  Billing department staff
Satisfied
Dissatisfied
Not Applicable
D.  Nurses
Satisfied
Dissatisfied
Not Applicable
E.  Nursing Assistants
Satisfied
Dissatisfied
Not Applicable
Your Comments:

2. The efficiency of our:

A.  Front desk receptionist
Satisfied
Dissatisfied
Not Applicable
B.  Telephone receptionist
Satisfied
Dissatisfied
Not Applicable
C.  Billing department staff
Satisfied
Dissatisfied
Not Applicable
D.  Nurses
Satisfied
Dissatisfied
Not Applicable
E.  Nursing Assistants
Satisfied
Dissatisfied
Not Applicable
Your Comments:

3.  How would you rate our nurses in terms of:
A.  Responsiveness to your questions
Satisfied
Dissatisfied
Not Applicable
B.  Time spent with patients
Satisfied
Dissatisfied
Not Applicable
C.  Medical knowledge
Satisfied
Dissatisfied
Not Applicable
Your Comments:

4.  How would you rate your appointments with us:
A.  Available in a reasonable amount of time
Satisfied
Dissatisfied
Not Applicable
B.  Scheduled at a convenient time of day
Satisfied
Dissatisfied
Not Applicable
C.  Completed in a timely manner
Satisfied
Dissatisfied
Not Applicable
D.  Availability with provider desired
Satisfied
Dissatisfied
Not Applicable
Your Comments:

5.  During your appointment with our PROVIDER do you feel:
A. The provider listened & answered your questions
Satisfied
Dissatisfied
Not Applicable
B. The examination was thorough
Satisfied
Dissatisfied
Not Applicable
C. The amount of time spent with you was appropriate
Satisfied
Dissatisfied
Not Applicable
Who was your appointment with?
Your Comments:

6.  Please rate our communication with you in the following areas:
A.  Were your calls answered promptly
Satisfied
Dissatisfied
Not Applicable
B.  Availability of medical information/advice by phone
Satisfied
Dissatisfied
Not Applicable
C.  The provider/nurse returning your call in a timely manner
Satisfied
Dissatisfied
Not Applicable
D.  Test results reported in a reasonable amount of time
Satisfied
Dissatisfied
Not Applicable
E.  Effectiveness of health information materials
Satisfied
Dissatisfied
Not Applicable
Your Comments:

7.  How did you hear about us?:

 Insurance Company    Internet     Newspaper    Freind or neighbor    

8.  How would you rate our facility:
A.  Hours of operation were convenient
Satisfied
Dissatisfied
Not Applicable
B.  Overall comfort of office
Satisfied
Dissatisfied
Not Applicable
C.  Adequate parking
Satisfied
Dissatisfied
Not Applicable
D.  Signage and directions easy to follow
Satisfied
Dissatisfied
Not Applicable
Your Comments:

9.  Overall rating:
A.  Our practice
Satisfied
Dissatisfied
Not Applicable
B.  Quality of your medical care
Satisfied
Dissatisfied
Not Applicable

10.  Would you recommend our office to a friend:

 Yes    No 

11.  If you would like a response to your survey:

 Please provide your name:
  
Daytime phone number:
  
Email address:



Property of Southern Medical Group, P.A.  All rights reserved.

1300 Medical Drive, Tallahassee Florida 32308

Call (850) 216-0100 for appointments