Patient Survey Please enable JavaScript in your browser to complete this form.How likely is it you would recommend us to a friend or colleague? Selected Value: 0 0 = Not at all likely 10 = Extremely likelyOverall, how satisfied or dissatisfied are you with the courtesy, respect, sensitivity, and friendliness of the front desk?Very satisfiedSatisfiedNeither satisfied nor dissatisfiedDissatisfiedVery dissatisfiedOverall, how satisfied or dissatisfied are you with the courtesy, respect, sensitivity, and friendliness of the nurses?Very satisfiedSatisfiedNeither satisfied nor dissatisfiedDissatisfiedVery dissatisfiedOverall, how would you rate the length of time spent waiting at the office for your appointment?Very satisfiedSatisfiedNeither satisfied nor dissatisfiedDissatisfiedVery dissatisfiedOverall, how satisfied or dissatisfied are you with the courtesy, respect, sensitivity, and friendliness of the Provider who examined you?Very satisfiedSatisfiedNeither satisfied nor dissatisfiedDissatisfiedVery dissatisfiedDuring this visit, my doctor adequately addressed all of my concerns. Very satisfiedSatisfiedNeither satisfied nor dissatisfiedDissatisfiedVery dissatisfiedHow satisfied are you with the physical environment of Alliance Medical Associates, PLLC?Very satisfiedSatisfiedNeither satisfied nor dissatisfiedDissatisfiedVery dissatisfiedOverall rating of your experience at our facility: Selected Value: 0 0 = Poor 10 = Extremely goodAdditional comments or feedback:Submit
