We are devoted to your health, your wants and your needs

Patient Survey Form

Please let us know if we are meeting all of your needs and how we can better serve you.

1. Scheduling an Appointment

Was it easy to schedule your appointment?
  Yes No
 Comments:
 

Was our staff friendly & helpful when answering your call?
  Yes No
 Comments:
 

Did we return your call promptly?
  Yes No
 Comments:
 

Was the wait-time to schedule an appointment reasonable?
  Yes No
 Comments:
 

Do you find our office locations convenient?
  Yes No
 Comments:
 

2. Check-in & Waiting

Was our staff friendly & helpful?
  Yes No
 Comments:
 

Did you find the waiting area comfortable?
  Yes No
 Comments:
 

3. During Your Exam

Was the exam room comfortable & pleasant?
  Yes No
 Comments:
 

Was our staff friendly & compassionate?
  Yes No
 Comments:
 

Was your doctor courteous during your exam?
  Yes No
 Comments:
 

Was your doctor willing to listen & respond to questions & concerns?
  Yes No
 Comments:
 

Did your doctor spend enough time with you?
  Yes No
 Comments:
 

Did your doctor clearly explain your exam results & treatment process?
  Yes No
 Comments:
 

4. Our Billing Process

Was our staff friendly & helpful?
  Yes No
 Comments:
 

Was billing for the services you received adequately explained to you?
  Yes No
 Comments:
 

If you contacted the billing office, please comment on the following:
Was it easy to contact a representative?
  Yes No
 Comments:
 

Was the representative courteous & helpful?
  Yes No
 Comments:
 

Were all of your questions answered to your satisfaction?
  Yes No
 Comments:
 

5. RMA of Philadelphia Complimentary Support Groups

Have you attended an RMA of Philadelphia support group?
  Yes No
 Comments:
 

If you have attended our support group, did you find it helpful?
  Yes No
 Comments:
 

Are you likely to attend an RMA of Philadelphia support group in the future?
  Yes No
 Comments:
 

6. RMA of Philadelphia wants to know

Was your overall experience with us positive?
  Yes No
 Comments:
 

Would you recommend RMA of Philadelphia to a family member or a friend?
  Yes No
 Comments:
 

Where do you feel we need the most improvement?
  Yes No
 Comments:
 

Additional Comments:
   

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We hope your experience with RMA of Philadelphia has been pleasant. Please feel free to call or email us with questions.

215-938-1515        info@rmaphiladelphia.com