Patient Survey Name* First Last Email* Enter Email Confirm Email GenderMaleFemaleAgeDoctor SeenVisit Date Date Format: MM slash DD slash YYYY Communication with Seaview OrthopaedicsIn general, there is good response time when communicating with the office.Strongly AgreeAgreeUncertainDisagreeStrongly DisagreeWhen I call the office for a prescription refill, I get a timely response.Strongly AgreeAgreeUncertainDisagreeStrongly DisagreeWhen I contact the office with a medical question or concern, it is addressed in a timely fashion.Strongly AgreeAgreeUncertainDisagreeStrongly DisagreeIt is important for me to have an electronic method (Patient Portal) to communicate with the office.Strongly AgreeAgreeUncertainDisagreeStrongly DisagreeIt is easy to use the Patient Portal.Strongly AgreeAgreeUncertainDisagreeStrongly DisagreeThe Patient Portal meets my needs when trying to communicate with the office.Strongly AgreeAgreeUncertainDisagreeStrongly DisagreeAccessIt is easy for me to schedule my appointment.Strongly AgreeAgreeUncertainDisagreeStrongly DisagreeThe person who scheduled my appointment was courteous.Strongly AgreeAgreeUncertainDisagreeStrongly DisagreeThe office hours are convenient for me.Strongly AgreeAgreeUncertainDisagreeStrongly DisagreeI was seen by the doctor within a reasonable amount of time of my scheduled appointment.Strongly AgreeAgreeUncertainDisagreeStrongly DisagreeThe staff in the reception area was courteous.Strongly AgreeAgreeUncertainDisagreeStrongly DisagreeI was kept waiting in the patient room for a longer time than I expected.Strongly AgreeAgreeUncertainDisagreeStrongly DisagreeDoctor: Regarding the doctor I most recently sawI thought the doctor spent enough time with me for my concerns.Strongly AgreeAgreeUncertainDisagreeStrongly DisagreeMy doctor treated me in a very friendly and courteous manner.Strongly AgreeAgreeUncertainDisagreeStrongly DisagreeThe instructions the doctor gave me about my condition/treatment plan were easily understood.Strongly AgreeAgreeUncertainDisagreeStrongly DisagreeI would say the doctor listened to me carefully.Strongly AgreeAgreeUncertainDisagreeStrongly DisagreeThe doctor included me in decisions regarding my treatment plan.Strongly AgreeAgreeUncertainDisagreeStrongly DisagreeI have confidence in this doctor.Strongly AgreeAgreeUncertainDisagreeStrongly DisagreeI would recommend this doctor to my family/friends.Strongly AgreeAgreeUncertainDisagreeStrongly DisagreeAdditional CommentsIf you feel there is anything not addressed in this survey, or if you have personal comments you would like to share with us, please use the following space provided. Thank you for your time. Please know that your input will help our practice maintain our patient-centered goals. We look forward to providing you with continued orthopedic and pain management care in the future.Captcha This iframe contains the logic required to handle Ajax powered Gravity Forms.
