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  • Evaluation Form

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    Martin Mambu
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    The clinic regularly measures patient satisfaction by providing a locked feedback box in the waiting area labeled "Please tell us how we're doing." Next to the box are pens, pencils, and blank feedback forms containing six questions regarding the date of visit, quality of medical care and customer service on a scale of 0 to 10, what was liked best and least about the visit, and suggestions for improvement.

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    The clinic regularly measures patient satisfaction by providing a locked feedback box in the waiting area labeled "Please tell us how we're doing." Next to the box are pens, pencils, and blank feedback forms containing six questions regarding the date of visit, quality of medical care and customer service on a scale of 0 to 10, what was liked best and least about the visit, and suggestions for improvement.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    5 views1 page

    Evaluation Form

    Uploaded by

    Martin Mambu
    The clinic regularly measures patient satisfaction by providing a locked feedback box in the waiting area labeled "Please tell us how we're doing." Next to the box are pens, pencils, and blank feedback forms containing six questions regarding the date of visit, quality of medical care and customer service on a scale of 0 to 10, what was liked best and least about the visit, and suggestions for improvement.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    Measurement: How Are We Doing?

    To judge customer service, the clinic regularly measures patient satisfaction. A


    locked, ballot-style feedback box is located in the waiting area. It is clearly labeled:
    "Please tell us how we're doing. Your feedback will help us make things better."

    Next to the box is a container holding pens and pencils and a stack of blank feedback
    forms. There are six questions on the one-page feedback form:

    1. What is the date of your clinic visit?


    2. How would you rate the quality of the medical care you've received? (Please
    circle one.) (poor) 0 - 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 (perfect)
    3. How would you rate the quality of the customer service you've received?
    (Please circle one.) (poor) 0 - 1 - 2 - 3 - 4 - 5 - 6 - 7 - 8 - 9 - 10 (perfect)
    4. What did you like best about this visit?
    5. What did you like least about this visit?
    6. Please suggest one or more ways we could make things better.

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