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Patient Satisfaction Survey
Untitled Document
Name *
Email *
Provider Seen *
I am between the ages of *
Before Your Visit
Did you feel that you were able to schedule an appointment in a reasonable time-frame from the time you contacted your provider's office? *
During Your Visit
Did you feel the office staff was friendly, available and willing to answer any questions or concerns? *
Did you feel that you received clear instructions or information on your condition or health? *
Are you comfortable with your treatment plan? *
After Your Visit
Do you know how to receive car or clinical advice from PPCP after-hours and on weekends? *
Do you feel confident in your ability to provide self-care and manage your condition and health? *
Do you feel you have access to your provider or members of the medical staff if you had any questions or concerns? *
If you were referred to another provider or had a lab or other medical test done, do you feel the appointment was scheduled or the results of your test were communicated in a timely manner? *
Comments: (Please do not include any personal medical information, for medical questions please contact your doctor's office directly.) *

Palmetto Primary Care Physicians
2500 Elms Center Rd, North Charleston, SC 29406
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