Athens Laser Skin Solutions

Satisfaction Survey

Athens Associates in Family Practice values your feedback! Complete the form below and click "submit". Your honest comments and advice is what continues to improve the quality of our care and helps us to better understand your needs. Thank you for completing the survey below. Please consider including your name and email address so we can better understand the circumstances surrounding your visit and your feedback. If you choose, we would love the opportunity to follow up with you. You name and email address will NOT be shared with any third party. We appreciate the opportunity to enhance our patient care and our services for you.

Athens Associates in Family Practice, providing superior healthcare to the Athens area for over 20 years!

1. Did you have trouble locating our office?

Yes
No

1a. If yes, please explain:

2. When I called the office during regular office hours, I received the help or advice I needed.

Yes
No

3. If I had to leave a message, I received a call back that same day.

Yes
No

3a. If no, what was the unreturned call regarding?

4. The front office staff met and greeted me promptly and courteously.

Yes
No

5. The nursing staff greeted me promptly and courteously.

Yes
No

6. The nurses spent an appropriate amount of time with me to understand and communicate my medical needs.

Yes
No

7. How long did you have to wait to see the provider?

8. The provider listened to me and my problems and showed respect and concern for what I had to say

Yes
No

9. The provider explained things in a way I could understand.

Yes
No

10. The provider spent enough time with me at this visit to discuss the problem I came in for.

Yes
No

11. Which provider (doctor) did you see?

12. When I checked out, the staff member collected my payment, or explained the insurance billing if needed.

Yes
No

13. If I received a referral to a specialist at my visit, it was handled in a timely manner and to my satisfaction.

Yes
No

14. I was satisfied with how quickly the office was able to arrange an appointment for me.

Yes
No

15. I would recommend your facility to others.

Yes
No

16. The rating I would give the staff and the provider for this visit at your facility.

Poor
Fair
Good
Excellent

Full Name

E-mail Address

Additional Comments and/or Suggestions

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Payment Information: We accept payments for services over and above your insurance coverage, such as co-pays and deductibles, in the form of cash and personal checks. We also accept Visa, MasterCard, and Discover cards.


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	Athens Associates in Family Practice 300 Hawthorne Lane Athens, GA 30606 Phone: 706.353.7648 Fax: 706.353.2771 All Emergencies Dial 911 NOTICE OF PRIVACY PRACTICES