• 360 W. Butterfield Rd | Elmhurst, IL 60126
  • 630.782.9600
  • 675 West North Avenue, Suite 314 | Melrose Park, IL 60160
  • 708.450.5744
  • 8 am to 5 pm Monday / Friday

Patient Experience Survey

Please, help us to improve our service by filling out the following survey.

Survey

1. Name

2. Phone

3. Which Provider did you see?
Dr. MeislesDr. HennessyDr. O’ConnorLaura Rachwalski, PA-CBrian Masterson, PA-CChristopher Orvino, PA-C

4. Which location where you at?
Melrose ParkElmhurst

5.How was the length of time in the waiting area?
ExcellentVery GoodGoodFairPoor

6.The length of time spent with the doctor or health care professional?
ExcellentVery GoodGoodFairPoor

7.Explanation of your condition and treatment options, in a way that was easy to understand?
ExcellentVery GoodGoodFairPoor

8.The manners (courtesy, respect, sensitivity, friendliness) of

8.a) Doctor

ExcellentVery GoodGoodFairPoor

8.b) Receptionist

ExcellentVery GoodGoodFairPoor

8.c) Physician Assistant

ExcellentVery GoodGoodFairPoor

8.d) X-ray technician

ExcellentVery GoodGoodFairPoor

8.e) Check out Staff

ExcellentVery GoodGoodFairPoor

9. How easy or difficult was it to schedule your appointment at a time that was convenient for you?
Very easySomewhat easyNeither easy or difficultSomewhat difficultVery difficult

10.The professionalism and helpfulness of the person(s) who scheduled your appointment?
ExcellentVery GoodGoodFairPoor