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Patient Satisfaction Survey

We appreciate your assistance as we try to improve our services. Please complete the form below to the extent you can. We will use this information
to identify our weaknesses and work to improve them. No attempt will be made to identify you. The data will be reported back to the office in
aggregate only. Please accept our thanks in advance for your help with this project. You may enter comments at the end.




1. When I called the office for an appointment, the length of time before the phone was answered was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


2. The length of time I spent on the phone to set my appointment was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


3. The number of days between my call and my actual appointment was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


4. The staff's helpfulness in scheduling my appointment was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


5. The convenience of the office hours was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


6. The staff's courtesy was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


7. The staff's promptness and efficiency were:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


8. The length of time, if any, that I had to wait past my appointment time was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


9. The staff's effort to explain the reason for any delay was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


10. The length of time I had to wait in the examination room before I saw the doctor was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


11. The doctor's effort to make me feel at ease was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


12. The doctor's understanding of the reason for my visit was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


13. The doctor's interest in my overall problems was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


14. The doctor's skill in examining me was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


15. The doctor's thoroughness in examining me was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


16. The doctor's explanation of each step of the examination was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


17. The doctor's explanation of my diagnosis was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


18. The doctor's encouragement for me to ask questions was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


19. The doctor's responses to my questions were:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


20. The clarity and thoroughness of the doctor's discussion with me about treatment options was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


21. The doctor's reassurance about my diagnosis and treatment was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


22. The doctor's encouragement to call if I had any problems or questions was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


23. The length of time the doctor spent with me was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


24. The staff's explanation of when and how I would here about the test results was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


25. The staff's help with scheduling any follow-up visits, referrals, or other tests was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


26. The staff's explanation of billing and payment/insurance issues was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


27. The staff's respect for my privacy was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


28. The doctor's ability to meet my needs was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


29. My overall satisfaction with the quality of care I received during this visit was:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply


30. My willingness to recommend Marin Neuropsychology Center to a close friend or family member is:

Excellent    Very Good    Good    Fair    Poor    Does Not Apply



(Optional) if you like us to respond to your comments, please eneter your email address:



Please confirm your e-Mail:



What provider(s) did you see?

Dr. Angelone
Dr. Prieto
Dr. Debellis

Please enter any other comments you have regarding our Center or your experience with us:



 


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