Blair Gastroenterology Associates Patient Survey Click here to download the PDF version of the Patient Survey Form. We want you to be pleased with the care and services you receive from the physicians and all of our staff at Blair Gastroenterology Associates. We will be grateful if you will complete this brief survey.Patient Name Patient PhonePatient Email* Today's Date* MM slash DD slash YYYY Were you greeted promptly and courteously upon arrival? Yes No Was your waiting time in the lobby, before being brought back to the examination room, acceptable? Yes No How long was your wait?Was your waiting time in the examination room, before the provider saw you, acceptable? Yes No How long was your wait?Before I saw the provider, the medical assistant introduced herself and was courteous to me? Yes No Did the provider take enough time to listen to everything you had to ask or say? Yes No Did the provider clearly explain his/her findings and clearly explain instructions for any follow up care? Yes No Were our billing and insurance policies made clear to you? Yes No Were our procedure “prep instructions” made clear to you? Yes No Would you recommend this practice to others? Yes No On a scale of 1 to 5, please rate the overall quality of care (1 is dissatisfied and 5 is very satisfied.) 1 2 3 4 5 Which Physician or Physician’s Assistant did you see during your visit today? Which Medical Assistant assisted you today?Physicians Dr. Defrancisco Dr. Mckibbin Dr. Alkhafaji Dr. Brzana Dr. Bouassaf Dr. Kerstetter Dr. Patel Physician’s Assistant Paul Augenstein, PA-C Dave Finochio, PA-C Melissa Lafferty, PA-C Todd Stasik, PA-C Michelle Kutruff, PA-C Chelsea Link, PA-C Gina Mickofsky, PA-C Mary Haney, PA-C Katie Fuller, PA-C Chelsea Buchanan, CRNP Medical Assistants Vicky Melissa Bethany Kim Gretchen Amanda Amber Jenny Krystle Missy Were you greeted promptly and courteously at the check—out desk? Yes No Check-Out Desk Uneeda Dawn Krystle Louanna Colleen Danielle Kathleen Did check-out clearly explain any follow-up appointments or testing your provider ordered? Yes No Do you have any other comments?Do you want the Administrator to contact you about any concerns you might have? Please Note: The Administrator cannot give medical advice, please contact your provider for any medical questions you may have. Yes No PhoneThis field is for validation purposes and should be left unchanged. Δ
