New Century Wellness Group Survey

The purpose of this questionnaire is to learn how the patients feel about the like the scheduling. It is very important
understand our patients concerns and provide the best services and ensure patient satisfaction. Please complete the
survey and return to the receptionist.

1 . What is the level of difficult when you book an appointment:

Very easy
Easy
Difficult
Very difficult
2. Ho long it takes to schedule an appointment?
Very short time
Short time
Long time
Very long time
3. How satisfied are you with the time taken to book you an appointment?
Very satisfied
Satisfied
Not satisfied
Very dissatisfied
4. How do you prefer to book your appointment?
Online
Phone call
Visiting clinic

5. What is the level of difficulty when you provide our clinic with your insurance information?
Very easy
Easy
Difficult
Very difficult
6. How accurate do you think is our billing to the insurance company?
Very accurate
Accurate
Inaccurate
Very inaccurate
7. How satisfied are you with our insurance procedures?
Very satisfied
Satisfied
Not satisfied
Very dissatisfied
8. How do you prefer to provide your insurance information?
Filling a form in the clinic
Online application
Phone call
9. Comments
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