{"id":847,"date":"2015-03-23T13:27:11","date_gmt":"2015-03-23T13:27:11","guid":{"rendered":"https:\/\/centerforpainfargo.com\/?page_id=847"},"modified":"2015-03-26T12:50:03","modified_gmt":"2015-03-26T12:50:03","slug":"take-a-survey","status":"publish","type":"page","link":"https:\/\/centerforpainfargo.com\/take-a-survey\/","title":{"rendered":"Take a Survey"},"content":{"rendered":"

[et_pb_section][et_pb_row][et_pb_column type=”4_4″][\/et_pb_column][\/et_pb_row][et_pb_row][et_pb_column type=”1_3″][et_pb_divider admin_label=”Divider” color=”#ffffff” show_divider=”off” \/][et_pb_image admin_label=”Image” src=”https:\/\/centerforpainfargo.com\/wp-content\/uploads\/2015\/03\/15571793_s.jpg” show_in_lightbox=”off” url_new_window=”off” animation=”left” sticky=”off” \/][\/et_pb_column][et_pb_column type=”2_3″][et_pb_text admin_label=”Text” background_layout=”light” text_orientation=”left”]<\/p>\n

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Patient Satisfaction Survey<\/h1>\n

We are continuously striving to improve our services to make your pain management experience more satisfying. Please take a few moments to answer the following questions. Your answers will remain anonymous unless you choose to identify yourself. Thank you\u00a0for participating.<\/p>\n<\/div>\n

[\/et_pb_text][et_pb_text admin_label=”Text” background_layout=”light” text_orientation=”left”] \n

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    \n\n\n\n\n\n\n<\/div>\n

    <\/strong>\n<\/p>\n

    PATIENT SURVEY:\n<\/h4>\n

    Provider Name: (required)\n<\/p>\n

    <\/span>\n<\/p>\n

    Your Name: (optional)\n<\/p>\n

    <\/span>\n<\/p>\n

    Date of Service:\n<\/p>\n

    <\/span>\n<\/p>\n

    <\/strong>\n<\/p>\n

    PLEASE RATE THE FOLLOWING:\n<\/h4>\n
    \n

    Our receptionist is friendly and helpful:\n<\/p>\n

      \nStrongly Agree<\/span><\/span>Agree<\/span><\/span>N\/A<\/span><\/span>Disagree<\/span><\/span>Strongly Disagree<\/span><\/span><\/span><\/span>\n<\/ul>\n
      \n

      You can schedule a convenient \/ timely appointment with your healthcare provider:\n<\/p>\n

        \nStrongly Agree<\/span><\/span>Agree<\/span><\/span>N\/A<\/span><\/span>Disagree<\/span><\/span>Strongly Disagree<\/span><\/span><\/span><\/span>\n<\/ul>\n
        \n

        You usually wait less than 20 minutes to see your healthcare provider:\n<\/p>\n

          \nStrongly Agree<\/span><\/span>Agree<\/span><\/span>N\/A<\/span><\/span>Disagree<\/span><\/span>Strongly Disagree<\/span><\/span><\/span><\/span>\n<\/ul>\n
          \n

          Your healthcare provider is professional and courteous:\n<\/p>\n

            \nStrongly Agree<\/span><\/span>Agree<\/span><\/span>N\/A<\/span><\/span>Disagree<\/span><\/span>Strongly Disagree<\/span><\/span><\/span><\/span>\n<\/ul>\n
            \n

            Your healthcare provider listens to your concerns:\n<\/p>\n

              \nStrongly Agree<\/span><\/span>Agree<\/span><\/span>N\/A<\/span><\/span>Disagree<\/span><\/span>Strongly Disagree<\/span><\/span><\/span><\/span>\n<\/ul>\n
              \n

              Your healthcare provider answers all your questions:\n<\/p>\n

                \nStrongly Agree<\/span><\/span>Agree<\/span><\/span>N\/A<\/span><\/span>Disagree<\/span><\/span>Strongly Disagree<\/span><\/span><\/span><\/span>\n<\/ul>\n
                \n

                Your healthcare provider adequately explains any tests or treatment options:\n<\/p>\n

                  \nStrongly Agree<\/span><\/span>Agree<\/span><\/span>N\/A<\/span><\/span>Disagree<\/span><\/span>Strongly Disagree<\/span><\/span><\/span><\/span>\n<\/ul>\n
                  \n

                  You usually receive your test results in a timely manner:\n<\/p>\n

                    \nStrongly Agree<\/span><\/span>Agree<\/span><\/span>N\/A<\/span><\/span>Disagree<\/span><\/span>Strongly Disagree<\/span><\/span><\/span><\/span>\n<\/ul>\n
                    \n

                    You would refer a friend or family member to your healthcare provider:\n<\/p>\n

                      \nStrongly Agree<\/span><\/span>Agree<\/span><\/span>N\/A<\/span><\/span>Disagree<\/span><\/span>Strongly Disagree<\/span><\/span><\/span><\/span>\n<\/ul>\n
                      \n

                      ADDITIONAL COMMENTS:<\/strong>\n<\/p>\n