Midway Medical Center - Clyde, Canton, NC

Please take a few minutes of your time to help us. Our goal is comfort, convenience, and satisfaction as well as quality medical care for all our patients. Please tell us about our medical services, including staff and physicians. Please complete this survey. Give us your opinions freely. You may use the area below to submit your comments or concerns.

Excellent ------- Poor

A. YOUR ARRIVAL	6	5	4	3	2	1
Was it easy for you to make an appointment?
Was the check-in process fast and efficient?
Was the waiting time in the reception area reasonable?
If your appointment time was delayed, were you informed?
B. OUR STAFF	6	5	4	3	2	1
Was check-in and check-out staff friendly and courteous?
Were the nurses/medical assistants caring and concerned?
Were your past test results reported in a reasonable amount of time?
C. YOUR VISIT WITH THE DOCTOR	6	5	4	3	2	1
Did the doctor listen to you?
Did the doctor take time to answer your questions?
Did the doctor spend enough time with you overall?
D. OUR FACILITY	6	5	4	3	2	1
Overall comfort
Hours of operation
Parking
E. OVERALL SATISFACTION WITH	6	5	4	3	2	1
Our practice
The quality of your medical care

Would you recommend the doctor(s) to others?	Yes	No
Would you recommend the practice to your family and friends?	Yes	No

If no, or if you have any suggestions that will help us improve our services, please tell us below:

Please indicate the Physician you saw:

Some information about you:

Your name (optional):

Thank you for your valuable assistance in completing this survey. Your comments will enable Midway to continually improve our services and the quality of care for the benefit of all our patients.