BAPTIST PRIMARY CARE / BAPTIST PEDIATRICS - Patient Satisfaction Survey - Regency Square
	Regency Square 9090 Regency Square Boulevard North Jacksonville, FL 32211 Please take a few minutes to answer the questions below. The information will be used to improve our services. All responses will be kept confidential and anonymous. 1.  Date of Visit:     2.  Physician / Provider Name: Please select a provider:Jeffry D. Altomare, M.D.Joseph Cronin, D.O.Risha Gatlin, M.D.Suzanne G. Godwin, M.D.Michael D. Janssen, M.D.Kirk M. Landau, M.D.Manuel B. Portalatin, M.D.James A. Waler, M.D.Tom Lundy, P.A.-C.Other   Other: (Please type in name) 3.  The following staff were professional, respectful and helpful: Reception Staff 1 2 3 N/A Poor Excellent   4.  The following staff were professional, respectful and helpful: Telephone Staff 1 2 3 N/A Poor Excellent   5.  The following staff were professional, respectful and helpful: RN, LPN, Medical Assistant 1 2 3 N/A Poor Excellent   6.  The following staff were professional, respectful and helpful: Laboratory Staff, X-ray Technician 1 2 3 N/A Poor Excellent   7.  Cleanliness of the office. 1 2 3 Poor Excellent   8.  Physician/Provider took the necessary time to answer my questions and concerns. 1 2 Unsatisfactory Satisfactory   9.  Physician/Provider was thorough in the explanation of the diagnosis and plan of treatment. 1 2 Unsatisfactory Satisfactory   10.  What was your wait time on the telephone? Less than 10 minutes   More than 10 minutes   More than 30 minutes   11.  What was your wait time in the lobby? Less than 10 minutes   More than 10 minutes   More than 30 minutes   12.  What was your wait time in the exam room? Less than 10 minutes   More than 10 minutes   More than 30 minutes