1. How did you hear about our practice?

2. How were you greeted upon your intitial contact with our office?

3. Ease of scheduling an appointment via phone?

4. Did you have any problem scheduling an appointment?

5. How would you rate the courtesy of the staff upon your arrival and during your wait?

6. How long did you wait in the reception area beyond your scheduled appointment time?

7. How long did you wait in the exam room before a clinical staff member appeared?

8. How would you rate the competence of the clinical staff that assisted you?

9. How would you characterize the concern our clinical staff showed for your need of treatment?

10. Which Health Care Provider examined you?

11. Did you feel a thorough examination was conducted by our health care provider?

12. Did the health care provider satisfactorily answer your questions?

13. If you had MOH's surgery, were you satisfied with the procedure and surgical experience provided by Dr. Carranza?

14. In MOH's surgery, were all of your questions and concerns addressed and answered?

15. Were you able to find the information you needed on our website?

16. Would you recommend our facility to your family and friends?

17. Please share your zip code:

18. Any additional comments or suggestions: