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Ask the Athletic Trainer

Cape Fear Sports Medicine, PA      

Cape Fear Sports Medicine strives to provide the highest quality of healthcare to our patients.  To help us continue to serve you better, we would like you to take a few minutes to complete the following questionnaire.  We assure you that your answers are strictly confidential, and will help us to maintain and improve the care that you and others receive.

 

1.  Phone calls are handled promptly and professionally.

        Strongly Agree  Agree    Neutral    Disagree    Strongly Disagree

2.  My appointment was made within a reasonable amount of time.

         Strongly Agree  Agree    Neutral    Disagree    Strongly Disagree

3.  The receptionist was helpful and courteous.

         Strongly Agree  Agree    Neutral    Disagree    Strongly Disagree

4.  During my visit, my wait time was reasonable.

         Strongly Agree  Agree    Neutral    Disagree    Strongly Disagree

5.  The nurse / assistant was helpful and courteous.

         Strongly Agree  Agree    Neutral    Disagree    Strongly Disagree

6.  My physician treated me with respect and concern.

         Strongly Agree  Agree    Neutral    Disagree    Strongly Disagree

7.  My physician adequately addressed my questions and concerns, and gave me understandable answers.

         Strongly Agree  Agree    Neutral    Disagree    Strongly Disagree

8.  I feel satisfied with the thoroughness and completeness of my medical treatment.

         Strongly Agree  Agree    Neutral    Disagree    Strongly Disagree

9.  I was given appropriate instruction by the office / nursing staff regarding my future appointment / treatment.

         Strongly Agree  Agree    Neutral    Disagree    Strongly Disagree

10.  Overall, I was pleased with my visit.

         Strongly Agree  Agree    Neutral    Disagree    Strongly Disagree

 

11.  Please provide comments or suggestions that will help us to provide the best care we can to our patients:

 

12.  How did you hear about Cape Fear Sports Medicine?

        If other, please specify: 

 

Please fill in the following information if you would like to be contacted:  (OPTIONAL)

Name 

Address 

City        State          Zip 

Phone     Email