Phoenix OB-GYN Associates, L.L.C - Medical Practice Limited to Obstetrics, Gynecology and High Risk Pregnancy


			Practice Profile

			Meet the Doctors

			Hospital Affiliation

			Laser Hair Removal

			Urinary Incontinence

			LEEP

			Clinical Trials

			Downloadable Patient Guides

			Downloadable Patient Forms

			Request a Patient Form

			Resources/Links

Scheduling Your Appointment

How easy was it to make an appointment by telephone?


Very Easy						Very Difficult

How long did you wait to speak to a scheduling staff member?


0 to 2 minutes	3 to 5 minutes	5 to 7 minutes	Longer

Was the person who scheduled your appointment courteous and helpful?


Very Courteous						Rude

Day of Your Appointment

Date of Visit

/ /

At which of the Phoenix offices were you seen?


Moorestown		Mount Holly		Medford		Columbus

How would you rate the courtesy of the staff at the reception desk?


Very Courteous						Rude

How long did you wait in the reception area beyond your scheduled appointment time?


0 to 5 minutes	5 to 20 minutes	20 to 40 minutes	Other

How long did you wait in the exam room before the physician/nurse practitioner appeared?


0 to 5 minutes	5 to 20 minutes	20 to 40 minutes	Other

Medical Assistant (blood pressure, weight, reason for visit)

Name:

How would you rate the courtesy of the medical assistant?


Very Courteous						Rude

The Doctor / Nurse Practitioner

Name:

Were you able to see the doctor/nurse practitioner of your choice?


Yes	No	N/A

Did you feel that your doctor/nurse practitioner spent an adequate amount of time with you?


Yes	No	N/A

How would you rate the competence of your doctor/nurse practitioner?


OutStanding	Good	Adequate	Needs Improvement	Poor	N/A

Did you feel that your doctor’s/nurse practitioner’s examination was thorough?


Yes	No	N/A

Additional Feedback

Please list any areas in which our service could be improved.

Please share any additional comments.

Main Office
110 Marter Avenue, Suite 505
Moorestown, NJ 08057
Office: 856-235-4840 | Fax: 856-235-3795