Patient Satisfaction is our Number One Goal
Dear Patient:

Our goal is to provide comfort, convenience, and satisfaction as well as the very best medical care to all our patients.

We would like to know how you feel about our medical services. Your comments will help us assure that we are truly responsive to your needs.

Thank you for your help.
PLEASE RATE THE FOLLOWING:

A. YOUR APPOINTMENT: Excellent Very Good Good Fair Poor N/A
1. Ease of making appointments by phone
2. Appointment available within a reasonable amount of time
3. Waiting time in the reception area
4. Keeping you informed if your appt time was delayed
B. OUR STAFF: Excellent Very Good Good Fair Poor N/A
1. The courtesy of the person who took your call
2. The friendliness and courtesy of the receptionist
3. The caring concern of our nurses/medical assistants
C. OUR COMMUNICATION WITH YOU: Excellent Very Good Good Fair Poor N/A
1. Your phone calls answered promptly
2. Getting advice or help when needed during office hours
3. Your test results reported in a reasonable amount of time
4. Your ability to contact us after hours
5. Your ability to obtain prescription refills by phone
D. YOUR VISIT WITH THE PROVIDER:
(Doctor or Nurse Practitioner)		 Excellent Very Good Good Fair Poor N/A
1. Willingness to listen carefully to you
2. Taking time to answer your questions
3. Explaining things in a way you could understand
E. YOUR OVERALL SATISFACTION WITH: Excellent Very Good Good Fair Poor N/A
1. Our practice
2. The quality of your medical care
3. Overall rating of care from your provider
 
F. WHICH PROVIDER DID YOU SEE?:
If there is any way we can improve our services to you, please tell us:
If you would like to be contacted regarding your experience with NOHC please provide us with the following information:

Name (required)
Date of Service (optional)
Email address (optional)
Phone (optional)
Address (optional)
Address 2
City
State
Zip
Thank you very much for your help!