Telehealth Patient Survey

Telehealth Patient Satisfaction Survey

Telehealth Patient Satisfaction Survey

Please share your opinion:
We would like to help in improving the quality and safety of our telehealth services. We continue to strive for excellence when providing medical care, so your honest responses are appreciated. This information will be kept confidential unless you request otherwise.

Excellent = Very Satisfied

Good = Satisfied

Fair = Neutral

Poor = Very Dissatisfied

Please indicate your level of SATISFACTION with the following:

The thoroughness, carefulness and professionalism of the Telehealth provider:

Poor

Fair

Good

Excellent

The courtesy, respect, sensitivity and friendliness of the Telehealth provider:

Poor

Fair

Good

Excellent

How well the Telehealth staff respected your privacy?

Poor

Fair

Good

Excellent

Your personal comfort in using the Telehealth system:

Poor

Fair

Good

Excellent

Your overall treatment experience at using Telehealth:

Poor

Fair

Good

Excellent

Would you use Telehealth again?

Yes

No

Would you recommend Telehealth to another person?

Yes

No

Comments on your stay (positive and negative)