Patient Satisfaction Survey

Thank you for allowing us to participate in your healthcare. At Virginia Beach Obstetrics and Gynecology, our goal is to make your experience with our practice as pleasant as possible. We value your insight with regard to how well we are accomplishing that goal.



1. Would you like to be contacted by our practice manager?
 Yes No

2. When you called our office to make your appointment:
- Was your call answered promptly and courteously?
 Yes No
- If you were put on hold, was the hold time acceptable?
 Yes No N/A

3. At the time of your appointment, were you greeted promptly and courteously upon your arrival?
 Yes No

4. If you had questions regarding your insurance coverage or payment options, were your questions answered to your satisfaction by our insurance/billing representatives?
 Yes No N/A
- Were discussions regarding payment arrangements handled confidentially and professionally?
 Yes No N/A

5. Did you find our waiting room to be acceptable (i.e. comfort, tidiness, temperature, reading materials)?
 Yes No
- Did you find the waiting time acceptable?
 Yes No
- How long did you wait to be seen?

6. Were you greeted appropriately by the nursing staff?
 Yes No
- Did you find that the nurse or medical assistant prepared you for the exam appropriately (i.e. directing you to the restroom, exam room, etc., instructing you on gowns, drapes, etc?
 Yes No

7. Did you find your encounter with the physician or physician assistant to be acceptable?
 Yes No
- Did you feel that the practitioner spent enough time with you and answered all of your questions?
 Yes No

8. Please rate your overall experience with us on a scale of 1-10:

9. Do you have any additional comments, questions or feedback?

10. Do we have permission to reproduce all or a portion of your comments on our website as a patient testimonial?
- If you answer yes, only your first name and last initial will be used. Thank you.
 Yes No