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Clearwater Office
Phone (727) 461-6026
Directions  

Countryside Office
Phone (727) 796-4740
Directions  

Bardmoor Office
Phone (727) 320-0800
Directions  

Trinity Office
Phone (727) 815-7551
Directions  

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:

Email Address:

Home address:

Home Phone #:

Work Phone #:

Insurance:

Who was your Physician?

What location did you visit?

Did you find our office location convenient?

How did you hear about us?

If you chose Physician referral, Online search engine, or Other above, please specify:

 

Please use the following scale to answer the questions below:
5 = Excellent | 4 = Very good | 3 = Average | 2 = Poor | 1 = Very poor

  1. How would you rate our switchboard and telephone service?
  2. Did you find it easy to make an appointment?
  3. Was our staff helpful?
  4. Did the doctor clearly explain the problem and the treatment he prescribed?
  5. Did you feel that the doctor was truly concerned for your well-being?
  6. Did your physician spend adequate time with you during your visit?
  7. Did you feel that your check out and bill payment was courteous and efficient?
  8. Was the staff helpful in helping you with your insurance coverage?
  9. Did our medical assistants make you feel comfortable?
  10. Do you feel you received the highest quality of care from your physician?
  11. Please rate your overall experience and quality of care provided by OAWF?
  12. What was your wait time?
  13. How many miles did you travel to reach our office?

Would you recommend OAWF to your family and friends?

If you answered no, please explain:

 

Do you have any comments or recommendations on how we might serve you better?

 

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