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Patient Feedback

Your opinions and feelings are important to us.

The doctors and staff of Orthopaedic Associates of West Florida are dedicated to giving you the highest quality medical care and the best possible personal attention. Please take a moment to complete this questionnaire to help us to serve you better!

Name
Phone		Email Address
Street Address
City		State	Zip
What location did you visit?		Who was your Care Provider?
Clearwater Office Clearwater MRI Countryside Office Bardmoor Office Trinity Office Trinity MRI		Please Select ---> Do Not Know Capozziello, Catherine E., PA-C Cooper, Andrew J., M.D. Cottrell, William C., M.D. Kilgore, John E., M.D. McClure, John M., M.D. Messer, Andrew C., M.D. McClure Norton, Julie, ARNP-C Odmark, Thomas E., M.D. Olsen, Dane, PA-C Phelan, Sean T., PA-C Pigeon, Richard, M.D., Ph.D. Richard, Eric, PA-C Rothberg, Michael L., M.D. Schwab, Thomas O., M.D. Schwartz, Craig A., M.D. Shea, Erin, PA-C Sinishtaj, Joseph, PA-C Swaringen, Jennifer, M.D. Tambay, Nishin S., M.D. Thompson, David P., M.D. Wisotsky, Scott M., M.D.
Did you find our office location convenient?
Yes No
How did you hear about us?		If you chose Physician referral, Search engine, or Other, please specify:
Physician Referral (specify -->) Google Other Search Engine (specify -->) Medical Guide/Directory Emergency Room Other (specify -->)
1. How would you rate our switchboard and telephone service?
Excellent Poor
2. Did you find it easy to make an appointment?
Excellent Poor
3. Was our staff helpful?
Excellent Poor
4. Did the doctor clearly explain the problem and the treatment he prescribed?
Excellent Poor
5. Did you feel that the doctor was truly concerned for your well-being?
Excellent Poor
6. Did your physician spend adequate time with you during your visit?
Excellent Poor
7. Did you feel that your check out and bill payment was courteous and efficient?
Excellent Poor
8. Was the staff helpful in helping you with your insurance coverage?
Excellent Poor
9. Did our medical assistants make you feel comfortable?
Excellent Poor
10. Do you feel you received the highest quality of care from your physician?
Excellent Poor
11. Please rate your overall experience and quality of care provided by OAWF?
Excellent Poor
12. How many minutes did you wait after your scheduled appointment time?
10 20 30 40 50 60+
13. How many miles did you travel to reach our office?
< 5 > 5 > 10 > 20 > 50 > 100
Would you recommend OAWF to your family and friends?
Yes No
If you answered no, please explain:
Do you have any comments or recommendations on how we might serve you better?

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