Keep Bodies in Motion
spacer

Name Phone Email

  
  
  
  
  
  
  
  
  
  

4. How was the courtesy, respect and helpfulness of the appointment scheduling staff?

Excellent
Very Good
Good
Fair
Poor

5. How was the courtesy, respect and helpfulness of the front office staff?

Excellent
Very Good
Good
Fair
Poor

6. How long did you wait at clinic for your appointment?

Less than 15 minutes
15-30 minutes
Over 30 minutes

7. Courtesy, respect, helpfulness of the medical staff (not including Physicians and PAs)

Excellent
Very Good
Good
Fair
Poor

8. How was the courtesy, respect, and helpfulness of the Physician or PA that you saw?

Excellent
Very Good
Good
Fair
Poor

9. Did the Physician or PA explain your condition in a manner you could understand?

Excellent
Very Good
Good
Fair
Poor

10. Did your Physician or PA give you the amount of time with them you felt you needed?

Excellent
Very Good
Good
Fair
Poor

11. How was the courtesy, respect and helpfulness of the check out staff?

Excellent
Very Good
Good
Fair
Poor

12. Did you have surgery performed by a Front Range Orthopaedics physician?

Yes
No

IF you checked "yes" to having a surgery performed by a Front Range Orthopaedics physician, we'd like to ask you a few more questions about your surgical experience.

13. How was the courtesy, respect and helpfulness of the person who scheduled your surgery?

Excellent
Very Good
Good
Fair
Poor

14. How well did Front Range Orthopaedics prepare you for your surgery?

Excellent
Very Good
Good
Fair
Poor

15. How well did Front Range Orthopaedics prepare you for your discharge from the surgery facility?

Excellent
Very Good
Good
Fair
Poor

16. How was the courtesy, respect and helpfulness of the billing staff?

Excellent
Very Good
Good
Fair
Poor

17. If you had the exact same situation again, would you still choose to have this procedure done?

Yes
No

18. Would you recommend Front Range Orthopaedics to family/friends?

Yes
No

19. If you have any additional comments or ideas, please share them with us! Thank you for your time!