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DANKNER FIERGANG EYE ASSOCIATES PATIENT SATISFACTION SURVEY

Every staff member at Dankner Fiergang Eye Associates is committed to your child’s eye care. We want you to have the very best service we can offer as dedicated professionals. In order to help us achieve this goal, we would appreciate your taking the time to complete this survey. This will help us to continually improve the quality of care that your family receives here. Your response will remain confidential.

1 Was this your first appointment as a new patient? Yes     No  
2 Have your calls to the office been handled courteously and efficiently? Yes     No
3 When you called, were you able to make an appointment in a reasonable amount of time? Yes     No
4 (NEW PATIENTS ONLY) Did our Welcome Brochure provide you with the information you needed? (directions, insurance information, office hours?) Yes     No
5 Was our staff courteous, friendly and helpful during the time you spent in our office? Yes     No  
6 Did our staff communicate with you regarding your child’s progress during the visit? Yes     No
7 Do you feel you had enough time with the doctor when you were here? Yes     No  
8 Do you feel your doctor interacted well with your child? Yes     No
9 Do you think that the office staff made a good effort to try to make your child comfortable during his/her exam? Yes     No
10 Do you feel the doctor explained your child’s condition and treatment in a clear and understandable manner? Yes     No  
11 Considering the services you received from our office, do you feel your waiting time was reasonable? Yes     No  
12 Would you recommend Dankner Fiergang Eye Associates to a friend? Yes     No  
13 Your overall satisfaction rating of your experience with our office was? Very Satisfied
Satisfied
Dissatisfied
     
OPTIONAL
Date Seen:
Location: Baltimore    Eldersburg     Westminster     Clarkesville
Examining Doctor:
Patient Name:
Phone Number: Home:    Work:
Cell:
Additional Comments:
 

Thank you for your time and effort in completing this survey. Please feel free to call and share any additional thoughts you may have with the office administrator.