1. The check-in process was efficient and pleasant.
   Strongly AgreeAgreeNo OpinionDisagreeStrongly Disagree
2. The medical assistant was pleasant and professional.
   Strongly AgreeAgreeNo OpinionDisagreeStrongly Disagree
3. The physician was professional and knowledgeable.
   Strongly AgreeAgreeNo OpinionDisagreeStrongly Disagree
4. The check-out process was efficient and pleasant.
   Strongly AgreeAgreeNo OpinionDisagreeStrongly Disagree
5. The overall medical care was professional and pleasant.
   Strongly AgreeAgreeNo OpinionDisagreeStrongly Disagree
6. The phone experience was pleasant.
   Strongly AgreeAgreeNo OpinionDisagreeStrongly Disagree
7. Date of Visit: (Optional)
8. Doctor Seen: (Optional)
9. Do you have any comments or suggestions about how we could improve your overall experience here at MacGregor Medical Center?
   
10. If you would like us to call you, please include BOTH name and phone number here:

    Name:
    Phone Number:

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