Community Health & Wellness Center

Community Health & Wellness Center of Greater Torrington
Patient Satisfaction Survey

We would like to know how you feel about the services we provide so we can make sure we are meeting your needs. Your responses are directly responsible for improving these services. All responses will be kept confidential and anonymous. Thank you for your time.

ABOUT YOU


Are you a Ryan White patient? Yes No

Age

Are you

Male Female

Ethnicity

Non Hispanic Hispanic

Race:

White Asian Pacific Islander Black/African America
American Indian/Alaska Native Unknown?

Check if you are a New Patient a New Patient Established Patient

What is your zip code?

How long have you been a patient?

1 year or less 1 - 3 years More than 3 year’s

Ease of getting care:

Ability to get an appointment when needed

Great Good Ok Fair Poor

Hours that we are open

Great Good Ok Fair Poor

Convenience of Center's location

Great Good Ok Fair Poor

Returned phone calls

Great Good Ok Fair Poor

Waiting:

Time in waiting room

Great Good Ok Fair Poor

Time in exam room

Great Good Ok Fair Poor

Waiting for tests to be performed

Great Good Ok Fair Poor

Waiting for test results

Great Good Ok Fair Poor

STAFF

Provider: (Physician, Nurse Practitioner, Dentist)

Listens to you

Great Good Ok Fair Poor

Explains things so you understand

Great Good Ok Fair Poor

Gives you good advice and treatment

Great Good Ok Fair Poor

Nurses, Medical Assistants, Dental Assistants’

Friendly and helpful to you

Great Good Ok Fair Poor

Answers your questions

Great Good Ok Fair Poor

Receptionists/Discharge Person/Billing

Friendly and helpful to you

Great Good Ok Fair Poor

Answers your questions

Great Good Ok Fair Poor

Facility

Neat and clean building

Great Good Ok Fair Poor

Ease of finding where to go

Great Good Ok Fair Poor

Comfort and Safety while waiting

Great Good Ok Fair Poor

Privacy

Great Good Ok Fair Poor

Confidentiality:

Keeping my personal information private

Great Good Ok Fair Poor

The likelihood of referring your friends and relatives to us:

Great Good Ok Fair Poor

Do you consider this center your regular source of medical care?

No Yes

What do you like best about our health center?

What do you like least about our Center?

Suggestions for improvement?

What did you think of this survey?

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Client testimonials

"Great healh care service providers and friendly staff. Thank you CHWC" Mary K., Torrington