How was your visit? Patient Satisfaction Survey Equal Access Clinic Network is always looking to improve! In doing so, your input as a patient is crucial. Help us provide better care to you by providing a short feedback survey on your most recent visit. Please be aware that this feedback is completely anonymous and you will not have to provide any personal information. General informationWhich Equal Access clinic did you visit?*Please select one...Tower RoadEastsideBartley TempleMain StreetI don't knowWas your most recent visit within the last two months?*Please select one...YesNoI don't knowFeedback from your most recent visitWere you able to sign in and receive paperwork immediately after arriving?Please select oneYesNoI don't rememberHow long was your waiting time between handing back paperwork and getting vitals measured?(Vitals include measurements of blood pressure, temperature, weight, etc.)Please select one...5 minutes or less10 minutes or lessMore than 10 minutesI don't rememberHow satisfied were you with the service you received from the undergraduate volunteer?(The undergraduate volunteer measured your vitals.)Please select one...Very satisfiedSomewhat satisfiedNeither satisfied nor dissatisfiedSomewhat dissatisfiedVery dissatisfiedDid you feel comfortable with procedures and service from the undergraduate volunteer?Please select one...YesNoHow long was your wait time between being seated again and being seen by a medical student?Please select one...10 minutes or less20 minutes or less30 minutes or lessMore than 30 minutesHow satisfied were you with the service you received from the medical student volunteer?Please select one...Very satisfiedSomewhat satisfiedNeither satisfied nor dissatisfiedSomewhat dissatisfiedVery dissatisfiedDid you feel comfortable with procedures and service from the medical student volunteer?Please select one...YesNoHow satisfied were you with the service you received from the physician?Please select one...Very satisfiedSomewhat satisfiedNeither satisfied nor dissatisfiedSomewhat dissatisfiedVery dissatisfiedWas your health issue addressed and was a plan (or a follow up appointment) established?Please select one...YesYes, but not to my satisfactionNoHow did you feel about your experience with Equal Access Clinic overall? Please select one...Very satisfiedSomewhat satisfiedNeither satisfied nor dissatisfiedSomewhat dissatisfiedVery dissatisfiedIf you submitted "somewhat dissatisfied" or "very dissatisfied" for any of the previous questions, please let us know why so we can improve.Potential servicesWhat resource would you like to see added to Equal Access Clinic services?Would you utilize free birth control?Please select one...YesNoNot applicable to meWould you be interested in accessing psychiatry help?Please select one...YesNoPlease submit any additional comments or criticisms here. We appreciate any suggestions for improvement in our clinics.EmailThis field is for validation purposes and should be left unchanged.
