Patient Satisfaction Survey

Which Patient Service Center did you go to during your most recent visit?
College St. Patient Service Center - 175 College Street Brookside Patient Service Center - 3600 Capital Avenue, S.W., Suite 206 Oak Ridge Patient Service Center - 391 South Shore Drive, Suite 216

Age:
under 30 30-50 51-70 over 70

Please mark a selection for each question below.	Poor	Fair	Good	Very Good	Excellent
Was the Patient Service Center in a convenient Location?
Was the Patient Service Center easy to find?
How would you rate the cleanliness of the reception area?
How would you rate the wait time before being called by the Receptionist?
How would you rate your overall experience with the Receptionist?
How would you rate the wait time before being called by a Phlebotomist?
How would you rate the professionalism and the care you received from the Phlebotomist?

Comments or suggestions:

OPTIONAL - Contact Information

Name

Phone

If you would like us to contact you about your experience at the Patient Service Center, please check the box below. Please be sure to provide your contact information

Please Contact Me