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Home > Offices & Services > Student Services > Student Health Services > Forms > Patient Satisfaction Survey

Patient Satisfaction Survey

Please answer the following questions about your experience with us:

Was I greeted by the receptionist in a warm, welcoming manner? Yes No

Was I seen by the N.P, P.A or M.D on time? Yes No

If not, how long was the wait from the scheduled time of appointment? < 5 minutes 5 -15 minutes > 15 minutes

Was the N.P, P.A or M.D kind and courteous? Yes No

Did you feel the N.P, P.A or M.D listened to you and valued your opinions? Yes No

If not, please explain below

How often did the N.P, P.A or M.D explain things in a way you could understand? Always Usually Sometimes Never

Were you satisfied with the cleanliness of the Health Services center? Yes No

Were you satisfied with the level of care you received today? Yes No

Was the atmosphere in the Health Services center a positive one? Yes No

Were all of your questions/concerns answered by the N.P, P.A or M.D? Yes No

Before given your medicine or prescription, how often did the staff tell you what it was for? Always Usually Sometimes Never

Before given your medicine or prescription, how often did the staff explain the possible side effects? Always Usually Sometimes Never

Would you recommend using the Health Services center to a fellow classmate? Yes No

If you wish to identify yourself for a follow-up interview, please leave your information below:

Name Email Phone number Date of visit Appointment with Type in the following two words

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Student Health Services
Student Health Center
Ground Floor, Stoddard C
100 Institute Road
Worcester, MA 01609-2280
Phone: +1-508-831-5520
Fax: +1-508-831-5953
healthcenter@wpi.edu

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