Please rate the services provided by HealthParters Central Minnesota Clinics during your most recent visit. Circle the number that best describes your experience.
("1" Strongly Disagree to "7" Strongly Agree) Overall 1. Overall, I am satisfied with my visit 1 2 3 4 5 6 7 2. I would recommend HPCMC to friends or family members for their health care needs 1 2 3 4 5 6 7Check-in 3. During this visit, the person at the check-in desk: Listened 1 2 3 4 5 6 7 Was Helpful 1 2 3 4 5 6 7Nursing 4. During this visit, the nurse: Was welcoming 1 2 3 4 5 6 7 Listened 1 2 3 4 5 6 7 Valued me as a patient 1 2 3 4 5 6 7 Gave me their full attention 1 2 3 4 5 6 7 Was respectful 1 2 3 4 5 6 7Physician/Provider 5. Please check the physcian who spent the most time with you during this visit. If you did not see a physician or provider, please leave blank and skip to question 9. Casey Amiot PA-C Scott Bammann MD Jennifer Fuchs PA-C Bernadette Hightower-Hughes MD Julie Johnson MD Patrick Lalley MD Paula Lindhorst MD Les Lofgren MD Mohamed Maray MD Jonathan Nelson MD Barry Radin PA-C Brad Rutten PA-C John Sebas MD Barbara Strandemo PNP Gary Strandemo MD Jan Suska CNP Pam Waage PNP Julie Zweiner MD6. During this visit, the physician/provider: Was welcoming 1 2 3 4 5 6 7 Listened to my problems 1 2 3 4 5 6 7 Had excellence medical knowledge 1 2 3 4 5 6 7 Explained what he/she was doing 1 2 3 4 5 6 7 Valued me as a patient 1 2 3 4 5 6 7 Answered questions about my problem 1 2 3 4 5 6 7 Used terms I easliy understood 1 2 3 4 5 6 7 Involved me in making decisions about my care 1 2 3 4 5 6 7 Provided clear instructions for treatment or care 1 2 3 4 5 6 7 Took enough time to examine me 1 2 3 4 5 6 7 7. Press one number to rate the medical care you recieved during this visit ("0" equals worst, "10" equals best): Your medical care during this visit 0 1 2 3 4 5 6 7 8 9 10 8. Would you recommend this Physcian/Provider to a friend? Yes NoWhy or Why not? Scheduling 9. For the first visit, the person scheduling my appointment: Listened 1 2 3 4 5 6 7 Valued me as a patient 1 2 3 4 5 6 7 Worked with my schedule 1 2 3 4 5 6 7 10. Which of the following best describes your wait time before entering the exam room? Less than 15 mins. More than 15 mins. with an explanation More than 15 mins. with no explanation 11. Which of the following best describes your wait time in the exam room before the physician/provider arrived? 5 mins. or less 6 to 10 mins. 11 to 15 mins. More than 15 mins. 12. What makes you most satisfied about this visit to HPCMC? About You HPCMC is committed to providing equal care to all patients. Please help us by answering these optional questions about yourself. If you are filling out the survey for the patient (a child, elderly parent, etc.) please answer questions 18-22 about the patient. 13. Your Gender Female Male 14. Your race: Native American Black/African American Hispanic/Latino Asian White 15. Your age: 10 or younger 11 to 17 18 to 29 30 to 44 45 to 64 65+ 16. How long have you been a patient at HPCMC? Less than 2 years 2 years to 5 years More than 5 years N/A 17. In the past year, how many visits have you made to this clinic (not counting visits to Behavorial Health, NovaCare, or dentist)? No visits 1 visit 2 or 3 visits 4 or more visits If you were not the patient (for example, you brought a child or elderly parent) please fill out this section about the patient: 18. Patient's gender: Female Male 19. Patient's race: Native American Black/African American Hispanic/Latino Asian White 20. Patient's age: 10 or younger 11 to 17 18 to 29 30 to 44 45 or older 21. How long has this patient been coming to HPCMC? Less than 2 year 2 years to 5 years More than 5 years N/A 22. In the past year, how many visits has this patient made it to this clinic (excluding visits to Behavorial Health, NovaCare, or a dentist)? No visits 1 visit 2 or 3 visits 4 or more visits We appreciate your comments, both positive and negative. Week # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53