lowcosthealthclinics.com Survey

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Date:

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Gender:

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Age:

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Reason for visit:
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Physical
Respiratory Infection
Stomach Pain
Diabetes
Hypertension
Other:

	Strongly Agree	Agree	Fair	Disagree	Strongly Disagree
Staff was friendly and courteous.
The treatment rooms were neat and clean.
The physician spent the time needed to evaluate my health needs
The physician understood and listened carefully to my health problems and concerns.
My questions were answered.
The physician was knowledgeable.
I was explained about the treatment/condition.
I was advised about general guide line to stay healthy.
The cost of the care was reasonable.
Overall, I was extremely satisfied with my visit.
I would most likely refer others to the clinics.
I will visit/come back to the clinic again.

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