1. 

I was able to schedule an appointment as soon as I wanted.

 

2. 

The person with whom I spoke about my appointment was courteous.

 

3. 

Please share specific improvement suggestions for the appointment process.

 

4. 

The appearance, comfort and neatness of the practice is excellent

 

5. 

Please share improvement suggestions for our facility.

 

6. 

The provider had reviewed my chart/records and was ready for our appointment.

 

7. 

My provider was sensitive to my needs and listened to what I said.

 

8. 

My provider clearly communicated the testing, diagnosis and plan.

 

9. 

I have confidence and trust in the provider who treated me.

 

10. 

Please share specific improvement suggestions for your provider.

 

11. 

I was treated with respect and dignity by the clinical nurses and staff.

 

12. 

Coordination of testing and follow-up care was handled in an outstanding fashion.

 

13. 

I was satisfied with the professionalism and expertise of the nurses and medical assistants.

 

14. 

Please share specific improvement suggestions for our clinical staff.

 

15. 

The front office staff treated me courteously.

 

16. 

The check-out process was a pleasant experience.

 

17. 

Please share specific improvement suggestions for the check-in and check-out processes.

 

18. 

The IVF training was very helpful in understanding the process.

 

19. 

Information and education on medications and my IVF protocol was appropriate and complete.

 

20. 

I am very satisfied with the process of my IVF treatment cycle.

 

21. 

Please share how we can improve the IVF Process.

 

22. 

The billing/insurance process was well explained, timely and convenient.

 

23. 

The various options for IVF payment were adequately discussed.

 

24. 

If insured, the staff was helpful in applying for the infertility benefits (if not, select N/A).

 

25. 

Please share specific improvement suggestions for billing.

 

26. 

Waiting time in the front office area was appropriate.

 

27. 

Any delays were explained to my satisfaction.

 

28. 

I found the practice website very helpful.

 

29. 

Please share improvement suggestions for our website.

 

30. 

How did you find out about our practice?

 

31. 

Please share your reasons for choosing our practice. (Reputation, Location, Insurance-Approved, High Pregnancy Rates, Specific Physician, Board-Certified Physician, Safety, Cost)

 

32. 

You will be my first choice if I need your specialty in the future.

 

33. 

I will recommend this practice to family and friends.

 

34. 

Please share the best thing about your visit.

 

35. 

Please share one thing you’d have us change to improve your experience.

 

36. 

Did you conceive?

 

37. 

Would you be willing to serve as a contact for other patients? If so, please share your contact information.

 

38. 

Would you like us to contact you regarding your survey responses? If so, please share your contact information.