Task | Completed (✓) |
---|---|
Ease of scheduling appointments. | |
Timeliness of appointment confirmation. | |
Availability of preferred dates and times. | |
Efficient check-in process upon arrival. |
Task | Completed (✓) |
---|---|
Cleanliness of waiting and examination areas. | |
Comfort and accessibility of seating and amenities. | |
Availability of parking or public transport options. | |
Clear signage and directions within the facility. |
Task | Completed (✓) |
---|---|
Friendliness and professionalism of front desk staff. | |
Courteousness and empathy were shown by the medical staff. | |
Effective communication during interactions. | |
Respect for patient privacy and confidentiality. |
Task | Completed (✓) |
---|---|
Time spent by the provider to explain the diagnosis and treatment. | |
Provider’s ability to answer patient questions thoroughly. | |
Perception of provider’s knowledge and expertise. | |
Clear communication of follow-up care instructions. |
Task | Completed (✓) |
---|---|
Satisfaction with the effectiveness of the treatment. | |
Minimal waiting times for procedures or treatments. | |
Adequate pain management or comfort measures. | |
Accessibility of prescribed medications or resources. |
Task | Completed (✓) |
---|---|
Opportunity to provide feedback on the experience. | |
Timeliness and effectiveness of follow-up appointments. | |
Resolution of concerns or issues raised by the patient. | |
Overall satisfaction with the care received. |
Overall Patient Satisfaction Rating:
Excellent
Satisfactory
Needs Improvement
Poor
Additional Comments:
[Insert any additional feedback, observations, or suggestions for improvement.]
Evaluator Name: [Your Name][Date Signed]
Patient Name: [Patient Name][Date Signed]
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