Patient Survey

Patient Satisfaction Survey

Monterey County Health Department Clinic Services

Please correct the field(s) marked in red below:

1
Date
 *
2
Select Your Clinic
 *
Select Your Clinic
3
How long have you been a patient here?
How long have you been a patient here?
4
Was the process of getting an appointment easy?
Was the process of getting an appointment easy?
5
Was the appointment time convenient?
Was the appointment time convenient?
6
For today's visit, do you feel that you waited too long?
For today's visit, do you feel that you waited too long?
7
How long did you wait for today's appointment?
How long did you wait for today's appointment?
8
Did the Medical Assistant ask you for the Name & Date of Birth before treating you or your child?
Did the Medical Assistant ask you for the Name & Date of Birth before treating you or your child?
9
Do all employees have visible nametags?
Do all employees have visible nametags?
10
Are you comfortable talking to your provider about your health issues?
Are you comfortable talking to your provider about your health issues?
11
Does your provider listen and show respect for your concerns?
Does your provider listen and show respect for your concerns?
12
Was the clinic staff respectful during your visit?
Was the clinic staff respectful during your visit?
13
Are you satisfied with the quality of medical treatment you received from us today?
Are you satisfied with the quality of medical treatment you received from us today?
14
Did you have trouble filling your prescription?
Did you have trouble filling your prescription?
15
Is the clinic clean?
Is the clinic clean?
16
Are the restrooms clean?
Are the restrooms clean?
17
How do you prefer to be contacted by the clinic?
How do you prefer to be contacted by the clinic?
18
Would you recommend this clinic?
Would you recommend this clinic?
19
Would you like information on how to enroll in MYCHART (MYCHART is electronic access to your personal health information)?
Would you like information on how to enroll in MYCHART (MYCHART is electronic access to your personal health information)?
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