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505 998 7400
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Survey
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Survey
Patient Satisfaction Survey
How satisfied were you wish the following aspects of your care
Availability
Unsatisfied
Satisfied
Neutral
Very Satisfied
Convenience
Unsatisfied
Satisfied
Neutral
Very Satisfied
Scheduling
Unsatisfied
Satisfied
Neutral
Very Satisfied
Environment
Comfortable
Unsatisfied
Satisfied
Neutral
Very Satisfied
Too Cold
Unsatisfied
Satisfied
Neutral
Very Satisfied
Too Hot
Unsatisfied
Satisfied
Neutral
Very Satisfied
Staff Friendliness
Unsatisfied
Satisfied
Neutral
Very Satisfied
Nurse Friendliness
Unsatisfied
Satisfied
Neutral
Very Satisfied
Nurse Response Time
Unsatisfied
Satisfied
Neutral
Very Satisfied
Provider/Doctor
Unsatisfied
Satisfied
Neutral
Very Satisfied
Wait Time (Lobby)
Unsatisfied
Satisfied
Neutral
Very Satisfied
Wait Time In Exam Room
Unsatisfied
Satisfied
Neutral
Very Satisfied
Prescription Filled Timely
Unsatisfied
Satisfied
Neutral
Very Satisfied
Overall Experience
Unsatisfied
Satisfied
Neutral
Very Satisfied
Please Rate RMA Overall
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Email*
First Name
Last Name
Area Code
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"Thank you, your feedback is greatly appreciated"
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