Park Avenue Medical

202 N. Park Avenue, Apopka, FL 32703

ph: 407-889-4711 / fax: 407-889-7742

Visit our family practice

and walk-in clinic

 

202 N. Park Avenue

Apopka, FL 32703

Get directions

ph: 407-889-4711

fax: 407-889-7742

Patient Survey

Please give us your feedback

Customer Survey

 

In an effort to better serve our patients, the staff and physicians would like to invite you to offer some feedback and rate your experience with us. Please help us to prioritize which area(s) we can improve to better take care of you. Thank you for your time. Your opinion is very important to us!

 

How would you rate the following aspects of our office? Please assign a number on a scale from 1 to 10 where "1" represents "Needs a lot of improvement" and "10" represents "Perfect as is".

 

 

1 2 3 4 5 6 7 8 9 10
Poor ---- Satisfactory ----- Great

 

Park Avenue Medical Patient Survey Form

1. Telephone System:
2. Check-in / Registration Process:
3. On Time for Appointment:
4. Check-out:
5. Referral Process:
6. Prescription Refill Process:
7. Overall Opinion of Staff:
8. Overall Opinion of Office:
9. Level of Health Care You Receive:
10. Website:
11 Your doctor (please select)
   
Additional Comments:  
The security word is:doctor  

Type the security word and click Submit:

© 2012 Park Avenue Medical