Medical Practice Survey

Everyone on our staff is dedicated to patient satisfaction. We invite you to take the brief survey below and tell us about your experience with our services. The information will be used to help us ensure that we are offering our patients the highest quality services and meeting all of their needs. Please do not include any personally identifying information in your response. If you would like someone to respond to any questions or concerns, please call Karla at 701.712.4027 or 800.472.2113 ext. 4027.

Your comments help us continue to improve our service to patients. For questions 2-8, please choose one answer that best describes your experience. 5 = Highly Satisfied,
1 = Not Satisfied

Items marked with an * are required.

How satisfied are you with our services?
Everyone on our staff is dedicated to patient satisfaction. We invite you to take the brief survey below and tell us about your experience with our services. The information will be used to help us ensure that we are offering our patients the highest quality services and meeting all of their needs. Please do not include any personally identifying information in your response. If you would like someone to respond to any questions or concerns, please call Karla at 701.712.4027 or 800.472.2113 ext. 4027. Your comments help us continue to improve our service to patients. For questions 2-8, please choose one answer that best describes your experience. 5 = Highly Satisfied, 1 = Not Satisfied Items marked with an are required.*

* Please indicate the name of the location where you were treated
* Was it was easy to schedule a convenient appointment?	5 4 3 2 1 N/A
* Were you greeted in a prompt and friendly manner?	5 4 3 2 1 N/A
* Were the doctor and staff sensitive to your needs?	5 4 3 2 1 N/A
* Was your waiting time reasonable?	5 4 3 2 1 N/A
* Were your concerns or questions answered?	5 4 3 2 1 N/A
* How would you rate the cleanliness of our facility?	5 4 3 2 1 N/A
* How would you rate the quality of care received from the doctor?	5 4 3 2 1 N/A
* How would you rate your overall experience?	5 4 3 2 1
* Would you return to our practice in the future?	Yes No
* Would you refer a friend to our practice in the future?	Yes No
Are there any services or conveniences we could provide to enhance your experience?
* Spam Check: 7 + 5 =

Medical Practice Survey

How satisfied are you with our services?

Get answers securely and confidentially with My MDC Chart / Patient Portal

Get answers securely and confidentially with
My MDC Chart / Patient Portal