Patient Satisfaction Survey

We are interested in providing you with the finest quality medical care. Please take a few minutes to complete this questionnaire evaluating Vincera Surgery Center, physicians and staff. All responses are anonymous, unless you wish us to respond to your individual concerns. Please respond freely, as all responses are kept confidential.


I am a:
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Procedure Date

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Ease of scheduling appointment
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Courtesy and efficiency of the OR staff
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Waiting time in the Surgery Center
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Courtesy and efficiency of the Pre-OP staff
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Courtesy and efficiency of the recovery room staff
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Understanding explanations regarding your procedure
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Courtesy and efficiency of the administrative support staff
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Thoroughness and proficiency of your physician
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Adequate amount of medication to control your pain
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Your physician's explanations, instructions and responses to your questions
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Physician's and staff's sensitivity to you
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Your understanding of follow-up care and further testing or procedures
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Ability to find the center easily from directions given to you
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Overall impression of our center
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Additional Comments:
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