Patient Survey

Name:

Phone:

Email:

Date of Your Visit

Who is Your Physician

Dr. Glenn Yates

Dr. James McLaughlin

Dr. Raghu Mukkamala

Dr. Rakesh Patel

Dr. Ana Tejero

Dr. Peter Krothapalli

When you called the office, was your call handled promptly and courteously?

Yes

When you arrived, were you greeted in a friendly manner?

Yes

How long was your wait time to see the physician? (From the time of your scheduled appointment until you saw the physician)

Less than 10 minutes

10-20 minutes

20-30 minutes

30-45 minutes

more than 45 minutes

Did your nurse seem caring and interested in your care?

Yes

Were you able to understand your doctor and the instructions given to you?

Yes

Did your doctor completely answer all of your questions?

Yes

If no, please explain...

Would you recommend our office to your friends and family?

Yes

Thank you for contacting us.
We will get back to you as soon as possible.

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11123 Chantilly Pkwy Ct., Unit L

Pike Road, AL 36064

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