Patient Survey

office phone: 334-262-0342
office fax: 334-262-0390

Patient Satisfaction Survey

* Indicates required field

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 No

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

Yes No

How long was your wait time to see the physician? *

Less than 10 minutes 10-20 minutes 20-30 minutes 30-45 minutes More than 45 minutes

From the time of your scheduled appointment until you saw the physician.

Did your nurse seem caring and interested in your care? *

Yes No

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

Yes No

Did your doctor completely answer all of your questions? *

Yes No

If no, please explain: *

Would you recommend our office to your friends and family? *

Yes No

Please use this field for additional comments regarding your visit, our staff, or our office. *

How did you hear about our survey? *

Email from Practice Employee Recommended Saw it while visiting the website

Would you like to be contacted regarding your visit? *

Yes No

Name *

First

Last

Phone Number *

Email *

Submit

Contact us at:
Phone: 334-262-0342
Fax: 334-262-0390
After Hours: 334-293-8000